15 April 2015

Everything you need to know about acute kidney injury on #NurChat

Up to 100,000 hospital deaths per year in the UK can be attributed to acute kidney injury, up to 30% of which could be prevented with the right care. About 65% of acute kidney injury cases start in the community, so what more could be done to help reduce its prevalence?

Acute kidney injury (often shortened to AKI) is the sudden and recent reduction in a person’s kidney function. We were thrilled to be joined by national NHS awareness campaign, Think Kidneys, who are working to raise awareness of the prevention, detection and treatment of AKI.

@ThinkKidneys AKI normally occurs in the context of other serious illness (e.g. sepsis) on a background of risk #NurChat

Access to fluids and the importance of adequate hydration are essential in the management of AKI, especially for residents in care homes and hospitals. As AKI often occurs in the context of other serious illness, fluids should be managed on an individual basis. For example, a person with heart failure should not drink excessively as this may be more harmful than beneficial. A personalised assessment upon admission to hospital should include hydration status and fluid requirements.

@clairestocks2 Accurate assessment of fluid status is essential. #NurChat

The 6 quality statements given in the NICE guidance on AKI is an essential source of information about the actions required to minimise and manage any potential occurrences of the condition.

Education has a significant role to play in working to reduce the resources spent managing avoidable instances of AKI. It’s estimated that just 1 in 2 people know their kidneys produce urine, with this number falling to just above 1 in 3 in the 16-24 age group.

@ThinkKidneys @NurChat - CQUIN will help in provision of full discharge summary info so should help with management

The guidance from the Commissioning for Quality and Innovation (CQUIN) 2015/16 was also welcomed as a tool for improving hospital discharge, which could help reduce readmissions as a result of AKI.

@ThinkKidneys About 65% of acute kidney injury starts in the community #NurChat

AKI is a condition that often begins in the community, so every healthcare professional has a role to play in its prevention and monitoring. Community and district nurses are especially important in championing the prevention of AKI. Fluid management in the community may be more challenging as some patients may withdraw from fluid intake in order to avoid instances of incontinence. This could be a result of feeling uncomfortable, vulnerable or the lack of aids to manage it appropriately.

There are some excellent resources available to for learning about AKI – see NICE eLearning portal or Nursing Times free module.

Join us again for the next NurChat on 28th April when we’ll be asking you about your personal manifesto for the NHS and healthcare in the UK.