The National Institute for Health and Care Excellence has published its first guideline on acute kidney injury (AKI) in the hope of saving thousands of lives as well as a hefty pile of National Health Service cash.
Acute kidney injury – which encompasses a wide spectrum of injury to the kidneys – is present in around one in five emergency admissions to hospital, and yet awareness of this potentially fatal condition is critically low among healthcare professionals.
The costs to the NHS of acute kidney injury (excluding costs in the community) are thought to be between £434 million and £620 million per year, which, NICE points out, is more than that associated with breast cancer, or lung and skin cancer combined.
And yet 20%-30% of cases are partially or fully preventable, highlighting the opportunity to reduce the number of AKI cases, thereby saving patient lives and reducing the related drag on resources.
NICE’s new guideline is essentially focused on improving the prevention, detection and treatment of the condition, as well as generally raising awareness of it.
GPs in particular can play a key role in identifying and treating patients with AKI, those who have developed AKI in the community, and to be involved in prescribing decisions where its risk may be reduced, the Institute says.
But it also recommends that AKI is tackled in hospital by people working in health across all specialties, not just renal units, from chief executives to healthcare assistants and, crucially, that healthcare professionals should be monitoring kidney function, including checking hydration levels and how regularly urine is passed.
“Small improvements in care have the potential to save thousands of lives each year”, NICE stressed.
It is hoped that the new guidelines will help instil a more consistent picture of good practice across the country, helping to address concerns that suboptimal care may contribute to the development of AKI.
In 2009, the National Confidential Enquiry into Patient Outcome and Death reported the results of an enquiry into the deaths of a large group of adult patients with the condition, describing systemic deficiencies in the care of patients who died from AKI, with just 50% of these patients having been judged to receive ‘good’ care.