The National Institute for Health and Clinical Excellence (NICE) has today (14 March 2013) published draft guidance which aims to cut the number of deaths caused by acute kidney injury (formally known as acute renal failure).

The NICE guideline, which will be published later this year, comes after the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) reported that suboptimal care may be contributing to development of acute kidney injury (AKI). The report describes systemic deficiencies in care of patients who had died of AKI: only 50% of those patients had received 'good' care.

Acute kidney injury (AKI) is seen in 13-18% of all people admitted to hospital, with older adults particularly affected. The number of inpatients affected by AKI means that has a major impact on NHS resources. The costs to the NHS (excluding costs in the community) are estimated to be between £434 million and £620 million per year, which is more than the costs associated with breast cancer, or lung and skin cancer combined.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: “Acute kidney injury is a huge problem for the NHS. In the past there have been concerns that not all patients had received ‘good' care and there have been unnecessary deaths due to deficiencies in care. The draft guideline aims to raise awareness amongst healthcare professionals to recognise and treat the condition early and focuses on prevention, recognition, therapy and timely access to specialist services for all.”

The draft recommendations aim to address known and unacceptable variations in recognition, assessment and initial treatment up to the point of renal replacement therapy. According to the draft guideline, the prevention of just 20% of cases of AKI could prevent thousands of deaths every year and substantially reduce complications and their associated costs.

Fiona Loud, Director of the Kidney Alliance and member of the NICE Guideline Commissioning Group said: “This draft guidance highlights the importance of raising awareness and providing education about acute kidney injury both to healthcare staff and the public. As this draft guidance becomes open for consultation on World Kidney Day we hope we can make people aware of the risks and reduce the vast number of people who are currently suffering from this avoidable condition.”

The draft guideline is primarily aimed at non-specialist clinicians who will care for most patients with AKI. It emphasises the importance of early intervention and stresses the importance of risk assessment and prevention. Healthcare professionals are encouraged to recognise symptoms and ensure treatment is provided at the earliest stage.

Professor Baker added: “We would urge all those registered as stakeholders in the development of this guideline to have their say on our draft recommendations, and submit their comments via the NICE website.”

The draft consultation runs from Thursday 14 March 2013 to Monday 29 April 2013.

Ends

Notes to Editors

1. The draft clinical guideline is available for consultation on the NICE website from Thursday 14 March 2013. Please contact the NICE press office for an embargoed copy of the draft guideline.

2. Only stakeholders can comment formally on consultations, but organisations can register throughout the development process and contribute from that point onward.

3. The final guideline is expected to be published in August 2013

4. National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report.

About NICE

1. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health

2. NICE produces guidance in three areas of health:

• public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
• health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
• clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS

3. NICE produces standards for patient care:

• quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
• Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients

NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence