The diagnosis and management of acute kidney injury: A complete audit cycle

6^th Annual conference on Clinical & Pediatric Nephrology

May 09-10, 2016 New Orleans, USA

Elena Charalambous, E Hannah, K Clamp, G Horner and H Gallagher

Bristol University, UK

Posters & Accepted Abstracts: J Nephrol Ther

Abstract :

Introduction: In 2009 NCEPOD reported only 50% of patients who had died of acute kidney injury received good care. In 2013 NICE produced guidelines on how to prevent, detect and manage those in AKI. Aim: This study aims to know does the Royal Surrey County Hospital comply with NICE Guidelines (CG 139) for the identification and management of acute kidney injury. Method: Patients in AKI were identified by their renal function blood results on the program 'WinPath'. Data was collected on a total of 20 medical and 20 surgical patients. By retrospectively reviewing their case notes we identified whether the correct diagnosis was made, the associated risk factors and if the appropriate investigations and management strategies were implemented. Interventions included teaching to junior doctors, distributing AKI alert cards and displaying posters on each ward. Results: The initial audit showed that only 38% of patients with AKI were correctly diagnosed. After the intervention this increased to 63% (70% for medicine, 55% for surgery). 95% of the patients had three or more risk factors. The most common risk factors included being over the age of 65, taking nephrotoxic drugs and having a diagnosis of hypertension. The Royal Surrey implemented 2 and a half times more management strategies only when AKI was correctly diagnosed in comparison to no diagnosis. Conclusion: The intervention has proven to be a success with the Royal Surrey increasing the rate of AKI diagnosis from 38% to 63%. This was achieved using relatively inexpensive, practical to deliver and straight forward techniques. Once AKI diagnosis is made, this allows for a better management plan. Nevertheless there is still room for improvement. Future considerations include a computerized warning system, focused drug chart reviews, an accessible guide to AKI management and a proforma to identify those at risk with the aim of prevention.

Biography :

Email: rmorris@allergy-care.net