The AKI Board met at the Department of Health in late March to consider how best to respond to “Adding Insult to Injury”, the NCEPOD report into AKI and how to ensure that lessons are learned and recommendations implemented. The group includes acute physicians, kidney care and intensive care network managers, intensivists, renal physicians and nurses, pharmacists, biochemists, radiologists and informatics experts as well as NHS Kidney care and Department of Health policy colleagues. They have identified a series of workstreams from education, risk assessment, early identification, access to specialist radiology, renal and intensive care expertise, e-prescribing and capacity within the system.
In terms of agreeing definitions, using the same language, engaging with colleagues outside of intensive care and specialist kidney services and implementing standard reporting and audit, AKI is about 5 years behind the CKD story but the parallels are clear.
Given the importance of AKI as an indicator of those who are acutely unwell, its association with prolonged length of stay and increased mortality, I am hopeful that we can, as a system, make progress at scale and pace to improve the quality of care for those with AKI.
A NICE clinical guideline on AKI (up to the point of requiring renal replacement therapy) has been agreed but there is much to do locally and nationally so we are ready and waiting to rapidly implement that NICE guideline when it is published in due course.