New national guidance released for post-discharge care following acute kidney injury

22 November 2019

Case note reviews undertaken to inform development of the RCGP Acute Kidney Injury Toolkit (AKI) in 2018 revealed variable, 'hit and miss' discharge information leading to additional workload in primary care to manage the uncertainties this created. Through national partnerships and collaboration between primary and secondary care, the RCGP has developed new national guidance for post-discharge care following acute kidney injury.

The RCGP Acute Kidney Injury Project Team has produced new guidance, which promotes tailored and timely discharge care for people who have had a hospital admission complicated by AKI. The guidance table and the Top Ten Tips are designed to support safer transitions of care and are relevant to both hospital and general practice teams. These new resources have now been integrated within the RCGP AKI toolkitPost-AKI Care section along with many useful resources for practitioners, patients and carers.

Why AKI?

Acute kidney injury is common, harmful and costly. It is a marker of illness severity that is associated with poor outcomes including high rates of unplanned re-hospitalisation as well as development or progression of chronic kidney disease. Placing an AKI diagnosis in clinical context is important to improve outcomes.

The new guidance includes recommendations about timeliness of clinical review after discharge, based upon AKI stage, clinical risk factors and degree of kidney function recovery. The resource promotes tailored and timely follow-up and seeks to address the safety risks that arise when patients transition between secondary and primary care. It highlights a need to address poor outcomes following AKI for people with heart failure.

Treat the person, not the test result

The guidance aims to maximise the utility of AKI as a driver of patient safety whilst minimise the potential for patient burden and unnecessary workload for clinicians. To achieve this, the guidance was developed using established consensus methodology that sought representation from the RCGP Overdiagnosis group.

The guidance was produced in partnership between the RCGP and Think Kidneys; the Academic Health Science Network (AHSN) for the North East and North Cumbria; Kent, Surrey and Sussex AHSN; NIHR Greater Manchester Patient Safety Translational Research Centre; NIHR Collaboration for Leadership in Applied Health Research and Care Greater Manchester; NHS Education for Scotland; and Healthcare Improvement Scotland. Aligning with wider recommendations, the guidance is endorsed by the British Society for Heart Failure. 



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