Post-acute kidney injury care: management of patients who have had an episode of care complicated by AKI

Greater ManchesterRenal and Urogenital
Start Date: 1 Feb 2016 End Date: 31 Dec 2017

About this project

This project aims to implement and evaluate novel interventions to manage patients who have had an episode of care complicated by acute kidney injury (AKI). Our key strategic objectives include:

  • To implement measures to improve the management of post-AKI care in the primary care setting
  • To understand the process of implementation
  • To measure the impact of the improvement work
  • To provide a platform for potential larger scale evaluation, by building on the currently limited evidence base
  • To inform the design of a sustainable model of care to support better medicine management in primary care.

Why is it important?

Maintenance of kidney health is central to addressing two global priorities: improving vascular health, and supporting people vulnerable to complications during episodes of acute illness. This project aims to support the development and delivery of interventions to support improved management following care complicated by AKI, a key group at risk of further complications.

AKI is a syndrome which is common, harmful and costly, and it’s estimated that 20% of cases are preventable. One in five emergency hospital admissions are associated with AKI, and it also increases the frequency, intensity and duration of hospitalisation. Furthermore, AKI is associated with significantly worse short and long-term outcomes including; higher risk of a further episode of AKI; increased risk of chronic kidney disease (including end stage renal disease); higher mortality rates both in the immediate and longer term.

With the recognition of the lack of current evidence around prevention of AKI, it is proposed that this project will instead focus on improving the management of post-AKI patients in general practice, to lessen the risk of reoccurrence.

How will we do it?

We will:

  • Undertake a post discharge audit of coding and follow-up management of patients with AKI to inform improvement work
  • Support GP practices via educational events to help them develop action plans for the management of patients who have experienced AKI in hospital
  • Qualitatively evaluate the process of implementing AKI alerts in primary care, exploring barriers and enablers to change
  • Assess the utility and cost effectiveness of this work through a health economics evaluation.
Dr Tom Blakeman