New guidelines for acute kidney injury – a 'silent killer'

Thursday 14 March is World Kidney Day. The theme is acute kidney injury (AKI); a serious condition that many people have never heard of.

Acute kidney injury (AKI) is where the kidneys quickly lose function within a few days. It is common and harmful – it is also avoidable and treatable. It affects about 20% of people who are admitted to hospital as an emergency.

AKI can be a silent killer, as there are no obvious symptoms in the early stages and the kidneys have often lost more than 50% of their function before it is diagnosed. This can lead to chronic kidney problems later on – or even kidney failure meaning the patient needs dialysis/ a kidney transplant.

AKI rarely occurs on its own, but is often a complication of other illnesses such as heart attack or liver disease or a serious infection.

The National Institute for Health and Clinical Excellence (NICE) is publishing new national guidelines tomorrow, aimed at increasing health professionals’ recognition and management of AKI so it is diagnosed sooner and managed better.

Dr Marlies Ostermann, a consultant in nephrology and critical care, was part of the group that has developed these guidelines: “It’s vitally important that doctors and nurses in all specialties become more aware of AKI. 20-30% of AKI could be prevented by ensuring that every patient admitted as an emergency is carefully assessed for their AKI risk, and that simple steps are taken in patients at high risk of AKI.”

A high price

Nick Palmer, a Guy’s kidney transplant patient, was the patient representative on the group: “AKI has a big human cost – these patients end up staying in hospital for longer, and have a greater risk of complications and death. In serious cases their kidney health may be permanently affected, which could result in renal failure. The only way to treat renal failure is with dialysis or a transplant. Home care, loss of work, and further complications are all a possibility.”

As well as the impact on patients, preventable AKI wastes healthcare resources. The NHS in London spends more treating AKI than on the four most common cancers (breast, prostate, bowel, lung).

Better prevention and diagnosis across the UK could save the NHS £130m-£186m per year.

About AKI

• Up to 750,000 cases/year in England: 60% (450,000) in people with no history of kidney disease, and 20-30% (150,000-225,000) are preventable
• The most common causes are infection, dehydration, and medication
• Risk factors include age, and long term conditions such as diabetes, chronic kidney disease, and heart or liver disease

Staff and patients are running an information stand on Thursday 14 March to support World Kidney Day. For information about AKI, kidney disease and organ donation visit Guy’s main reception 9am-3pm.