RCPE/NHS Kidney Care Press Release
21 November 2012
New UK-wide medical guidance published today will advise that by implementing a simple system of e-alerts, amongst other measures, the NHS could turn around a 40 year high level of patient deaths caused by acute kidney injury (AKI) and save up to 12,000 lives per year.
Approximately 20% of patients admitted to hospital in the UK have acute kidney injury (AKI). AKI has a high death rate (10-80% depending upon population studied [1]) and its cost of treatment is considerable. Kidney disease, of which AKI is one of the main forms, costs more than treating breast, lung, colon and skin cancer together. AKI is largely a secondary illness associated with a number of conditions including loss of blood volume following traumatic accidents or surgery, heart attacks or dehydration, all of which may result in a reduction of the circulation to the kidneys. Non-kidney specialists are often involved in treating the early forms of AKI and treatment, particularly in the form of the administration of fluids and adjustment of medication, can be critical in reducing the severity of AKI. The opportunity for these approaches however is often missed. Death rates from AKI have not reduced in the last 40 years and the National Confidential Enquiry into Patient Outcomes and Deaths (NCEPOD) report in 2009 found that 50% of AKI patients who died did not receive an adequate standard of care for their kidney disease.
Against this background, a UK-wide meeting was convened by the Royal College of Physicians of Edinburgh (RCPE) [2], with the support of NHS Kidney Care [3], to reach consensus on how to improve the diagnosis and management of AKI. The two-day meeting, attended by over 100 health care professionals, including kidney specialists from around the UK, was held in Edinburgh last weekend and produced much-needed new UK-wide guidance, in the form of the RCPE UK Consensus Statement on AKI, which is published today Key recommendations include –
The Consensus Statement will be sent to the UK and Scottish Governments to inform future health policy and to related guideline developers, including the National Institute for Health and Clinical Excellence (NICE) and the Scottish Intercollegiate Guidelines Network (SIGN), to inform guideline development. It will also be sent to all Medical Directors of NHS Trusts and Boards throughout the UK to inform clinical practice.
Dr Mike Jones, Vice President of the Royal College of Physicians of Edinburgh, and lead organiser of the event, said,
“Acute Kidney Injury is a significant cause of death and disability. While there have been many medical advances in recent decades, death rates caused by AKI have not reduced in the last 40 years. As such, it is essential that the NHS recognises that urgent action is required to address this. Central to this is the need for early identification and treatment which could improve patient outcomes immeasurably.
“While further research is needed, it is clear that we cannot wait for the evidence to evolve fully before acting. We have, therefore, made recommendations based upon the best available evidence to date regarding a number of practical and new measures which could be implemented in the near future. In addition to improving the care for patients, there is tremendous potential to benefit the NHS, as it has been estimated that the savings derived through early identification and treatment of AKI could pay for another 2-3 nurses in every hospital throughout the country.”
Dr Donal O’Donoghue, National Clinical Director for Kidney Care, said,
“It has to be recognised that AKI has the potential to affect any acutely unwell individual patient in the community, admitted to hospital or undergoing surgery. It is, therefore, essential that we have a high level of vigilance and that all doctors, and not just kidney specialists, are trained to identify early symptoms of AKI and that appropriate treatment is administered.
“We have intentionally reviewed the evidence in relation to important clinical areas which are not the main focus of recent or planned guidelines and would urge early adoption of our recommendations.”
Beverley Matthews, Director of NHS Kidney Care, said,
“There is a clear need for more guidance to help healthcare professionals reduce the incidence of AKI and improve the care and outcomes of those who develop AKI, and these recommendations are a very welcome development.
“At NHS Kidney Care, we work with healthcare professionals in acute trusts and beyond to develop educational and practical tools designed to support the improvement of diagnosis and management of AKI.”
Contact: Graeme McAlister on 0131-247-3693 or 07733-263453
ENDS
Notes to Editors
[1] Death rates resulting from AKI vary significantly, ranging from 10% (in cases of uncomplicated AKI), through 50% (cases involving multi-organ failure) to 80% (patients requiring kidney replacement therapy)] Source: The Renal Association.
[2] The Royal College of Physicians of Edinburgh (RCPE) is a professional membership organisation concerned with promoting high standards of patient care. While based in Scotland, it has significant numbers of members throughout the rest of the UK and internationally. RCPE UK Consensus Conferences are convened in areas in which the evidence is grey or there is clinical uncertainty and in which practical interim clinical guidance is required by the NHS while further evidence evolves.
[3] NHS Kidney Care is funded by the NHS in England and works with health care professionals and commissioners to improve every aspect of kidney care for patients. From improved prevention and early diagnosis through to better end of life care, NHS Kidney Care supports healthcare professionals to understand and implement new guidelines, standards and national priorities and supports patients and their carers to make more informed choices and live life to the full.
