AKI in Primary Care

Start Date: 31 Jan 2015 End Date: 30 Jun 2018

The Hampshire Acute Kidney Injury Study

Acute kidney injury (AKI, a rapid reduction in kidney function) is common and under-recognised in the NHS and associated with poor clinical outcomes and high healthcare costs. A significant proportion of AKI is potentially preventable and two thirds of AKI seen in hospital is estimated to have arisen in the community. This study aims to use data in the Hampshire Health Record (HHR, an anonymized shared clinical database) to identify the incident rate, risk factors and outcomes of AKI, to develop and validate a predictive score for community-acquired AKI and to evaluate the effect of the introduction of hospital and primary care AKI e-alerts. It will also evaluate the effectiveness of an AKI-education intervention for hospital clinicians and GPs, and estimate the costs of AKI in Wessex and the cost-effectiveness of the education interventions. To achieve these aims, it will use a cohort design incorporating all people in HHR GP practices (estimated about 600,000 people with complete data) followed for up to five years and assess those admitted to hospital and those not admitted for AKI using a standardized national algorithm based on changes in serum creatinine values. It will link with the Wessex Cardiovascular Disease Network’s AKI initiative in order to inform and evaluate the education interventions. Outcomes from the study will be disseminated locally and nationally and influence clinical practice in Wessex to improve the prevention, identification and management of AKI.

Dr Simon Fraser