HSJ highlights increasing acute kidney injury (AKI) costs

The Health Service Journal has picked up on the large increase in kidney care spending identified in the recently published programme budgeting:

“Latest figures revealing the spiralling cost of treating kidney disease highlight trusts’ failure to tackle the growing problem of acute kidney injury, HSJ has been told.

Data published by the Department of Health this month shows the NHS spent £1.64bn on treating renal problems in 2009-10 – a 23 per cent increase on the previous year.

It was the largest year on year increase of all the major disease categories and now accounts for about £11m annual spending by each primary care trust.

Although some of the increase is due to improved data recording, experts told HSJ a major cause was the rapid growth in acute kidney injury commonly caused by dehydration or poor bloodflow. Activity figures seen by HSJ show the number of hospital admissions for such injuries grew by 11.5 per cent in 2009-10, and the number of bed days used by them grew by 10.1 per cent.

Royal Free Hampstead Trust consultant nephrologist Chris Laing, who is chair of the north central London acute kidney injury network, said up to 20 per cent of people admitted to hospital now have some signs of the problem, yet it often goes unnoticed.

Dr Laing told HSJ that despite previous warnings of the growing problem – it was highlighted in a 2009 National Confidential Enquiry into Patient Outcome and Death report – many hospitals were failing to detect patients early. He said: “There are deficiencies in care and it would not be an overestimate to say this is a major healthcare challenge.

“There is a high prevalence, and it is hugely costly both in patient outcome and financially.
It is preventable and treatable.”

A DH spokeswoman said: “Part of the reason the NHS is spending more treating renal disease, is that acute kidney injury is more frequently being diagnosed and recorded.” She added: “We have asked the National Institute for Health and Clinical Excellence to provide definitive clinical guidance [and are] working with healthcare partners to develop new tools for addressing acute kidney injury, including routine risk assessment for all emergency admissions.” “