{"id":2497,"date":"2015-12-08T11:50:14","date_gmt":"2015-12-08T11:50:14","guid":{"rendered":"http:\/\/www.thinkkidneys.nhs.uk\/aki\/?p=2497"},"modified":"2015-12-11T13:27:13","modified_gmt":"2015-12-11T13:27:13","slug":"acute-kidney-injury-its-a-risky-business","status":"publish","type":"post","link":"https:\/\/www.thinkkidneys.nhs.uk\/aki\/blog\/acute-kidney-injury-its-a-risky-business\/","title":{"rendered":"Acute kidney injury: It\u2019s a Risky Business"},"content":{"rendered":"

Andy Lewington and Sarah Harding on behalf of the Risk Workstream<\/strong><\/p>\n

The Risk workstream of the Think Kidneys programme has devoted a lot of time into looking at how people \u201cat risk\u201d but who haven\u2019t had Acute Kidney Injury (AKI) can be identified and cared for to minimise their risk of an event.<\/p>\n

There are no specific treatments for the most common forms of AKI other than good medical care and treatment of the underlying cause which is most often sepsis and low blood pressure. Prevention of AKI is therefore essential. It has been estimated that as many as 30% of cases of AKI could be prevented. Economic evaluation of the cost of AKI to the NHS has demonstrated that there will be significant savings if we could improve our detection of patients at high risk of AKI and implement appropriate preventative measures.<\/p>\n

Unfortunately there are currently no validated AKI risk calculators that are uniformly used across the NHS. There is therefore an immediate need to develop such tools. The Risk workstream has a number of ongoing projects looking at developing such risk calculators. Early indications are that patients at higher risk are those of older age and with chronic kidney disease. It may be argued that that is not particularly helpful information to a general practitioner in busy surgery! Undoubtedly further work needs to be done but there are a green shoots appearing most recently in the BMJ there was an AKI risk calculator for patients undergoing orthopaedic surgery. We will keep you posted.<\/p>\n

Following a very productive meeting in London the Risk workstream has started to develop \u201cat Risk of AKI\u201d card that can act as a point of communication between patient and various health professions. The card would be offered to patients during a routine GP care planning event, like an annual review in primary care or following an episode of AKI in secondary care. To help deliver this advice the health profession should assist the patient\/carer with the specific reason they are considered at higher risk of AKI and if indicated give specific advice. The card would then empower the patient to help other health professions \u201cthink kidneys\u201d when they present with acute illness or need their medication changing.<\/p>\n

Further projects include the development of an AKI risk matrix for primary and secondary care which identifies patients with inherent risks of AKI and how exposure to other insults such as sepsis or hypotension may further increase the risk of AKI. Such patients should have preventative measures instituted early and heightened surveillance. The group has proposed the adoption of the STOP AKI management acronym which has been recently published in the Royal College of Physicians AKI and Intravenous Fluids acute care toolkit. It promotes the implementation of a number of measures that include screening for sepsis, avoiding toxins, optimising blood pressure and preventing harm by identifying the underlying cause, treating complications, reviewing medication doses.<\/p>\n

The Risk workstream will come together with the Intervention work stream in January 2016 to harmonise these important developments. Merry Christmas and a Happy New Year.<\/p>\n","protected":false},"excerpt":{"rendered":"

Andy Lewington and Sarah Harding on behalf of the Risk Workstream The Risk workstream of the Think Kidneys programme has devoted a lot of time into looking at how people \u201cat risk\u201d but who haven\u2019t had Acute Kidney Injury (AKI) can be identified and cared for to minimise their risk of an event. There are no specific treatments for the most common forms of AKI other…<\/p>\n","protected":false},"author":114,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":["post-2497","post","type-post","status-publish","format-standard","hentry","category-blog"],"acf":[],"yoast_head":"\nAcute kidney injury: It\u2019s a Risky Business - Acute Kidney Injury<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.thinkkidneys.nhs.uk\/aki\/blog\/acute-kidney-injury-its-a-risky-business\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Acute kidney injury: It\u2019s a Risky Business - Acute Kidney Injury\" \/>\n<meta property=\"og:description\" content=\"Andy Lewington and Sarah Harding on behalf of the Risk Workstream The Risk workstream of the Think Kidneys programme has devoted a lot of time into looking at how people \u201cat risk\u201d but who haven\u2019t had Acute Kidney Injury (AKI) can be identified and cared for to minimise their risk of an event. 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