New NICE kidney guideline to save thousands of lives

The National Institute for Health and Care Excellence (NICE) has published a new guideline which promises to save thousands of lives and hundreds of millions of pounds each year. The new guideline will help prevent, detect and treat acute kidney injury (AKI), a condition that affects one in six people who are admitted to hospital and although it is completely preventable, can lead to death in one in four of those.

Evidence suggests a lack of education about the condition among healthcare workers. The NICE guideline aims to raise awareness and recommends that AKI is tackled by people working in health across all specialties, not just renal units, from chief executives to healthcare assistants.

Conservative estimates suggest that currently between £434million and £620million is spent on treating acute kidney injury. This is more than the NHS spends on breast cancer, or lung cancer and skin cancer combined. The guideline will cost the NHS very little to implement.

Early detection of AKI is a key priority and will prevent the patient's condition becoming critical. If the acute kidney injury is not picked up in time it can lead to the kidneys becoming overwhelmed and they will shut down leading to irreversible injury or possibly death. Healthcare professionals should be monitoring their patient's kidney function including checking hydration levels and how regularly they are passing urine. Small improvements in care have the potential to save thousands of lives each year.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: “Acute kidney injury is a huge problem for the NHS. This new NICE guideline aims to raise awareness among healthcare professionals to recognise and treat the condition early and focuses on prevention, recognition, treatment and timely access to specialist services for all.”

Dr Mark Thomas, Consultant Physician and Nephrologist at Heart of England NHS Foundation Trust and Chair of the Guideline Development Group for the guideline, says: “Many hospitals and healthcare professionals have been doing an excellent job in watching out for acute kidney injury in their patients, but unfortunately this good practice is not seen everywhere. The NICE recommendations give the NHS clear advice to reduce the number of avoidable deaths through acute kidney injury. Trusts that already perform to an excellent standard are encouraged to share their good practice and those that have not been performing so well are encouraged to ensure that AKI is taken seriously and their staff are well trained in the prevention and detection of the condition. Not only can we save lives with this guideline but the money we save could be put back into general NHS care.”

Coral Hulse, Nurse Consultant, Critical Outreach Service at Mid-Cheshire Hospitals and Guideline Development Group member says: “These NICE guidelines are aimed at all healthcare professionals, but as front-line staff, nurses can play a key role in watching out for the signs and symptoms of kidney problems in their patients. Monitoring fluid intake and how much urine is passed is vital in the war against acute kidney injury as is monitoring the medication the patient takes and checking results as soon as they are available.

“These guidelines come at a time when staffing levels are being scrutinised and front-line staff are busier than ever, but remembering the key things and taking a little extra time can actually prevent someone developing a life threatening condition that will cost even more time and much more money.”

Fiona Loud, Director of the Kidney Alliance and lay member on the guideline development group says: “Acute kidney injury is something that happens really quickly. Within a few hours your condition can become life-threatening, and it is completely avoidable. When something goes wrong in the body the kidneys often suffer the consequences. Patients also play a role in the prevention and detection of AKI. Make sure you drink plenty of water and are regularly going to the toilet are ways to avoid the condition. Making your GP or healthcare provider aware of any unusual changes in your body and being kidney aware is also vital.”

Ends

Notes to Editors

About the clinical guideline

  • Is there any age profile breakdown of the groups more at risk?

There is an associated risk for older people, and most recent studies of the condition show an average age in the seventies. With the UK's aging population, the risk of AKI is likely to increase over time.

Generally, age and co-morbidity, such as diabetes, are key factors in determining risk.

  • What proportion of cases are preventable?

Some 20-30% of cases of AKI are regarded partially or fully preventable. This figure is around 12,000 per year.

  • The costs estimate - how does that break down?

In her report The Economic Impact of Acute Kidney Injury (not yet published), NHS Kidney Care health economist Marion Kerr estimates how much the NHS in England spends on AKI in a year, using datasets like Hospital Episode Statistics (HES) and reference costs. She has calculated the national cost of AKI at between £434 million and £620 million per annum.

About NICE

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This page was last updated: 27 August 2013