Better kidney care 'could save up to 42,000 lives'

The number of deaths due to treatable kidney problems could be reduced by thousands, according to new NHS guidance.

If hospital patients were given the optimum level of care, the number of deaths could be reduced by between 12,000 and 42,000, it is claimed.

Simple checks could prevent around 100,000 cases of AKI

Carrying out simple checks, such as ensuring patients are hydrated and their medicines are reviewed, could prevent around 100,000 cases of acute kidney injury (AKI) across England.

Figures from the National Institute for Health and Care Excellence (NICE) suggest the annual NHS bill due to AKI is between £434 million and £620 million a year - more than it spends on breast, lung and skin cancer combined.

AKI, which was previously known as acute renal failure, refers to a loss of kidney function and it can develop very quickly.

It can occur in patients who are already ill with conditions such as heart failure or diabetes; those admitted to hospital with infections; or those recovering from a major surgery, such as a heart operation when the kidneys have been deprived of normal blood flow.

Failure to detect the condition quickly can lead to the kidneys shutting down, which can cause serious illness or even prove fatal.

Up to 1 million people admitted as an emergency will have AKI

Figures suggest that between 262,000 and 1 million people admitted to hospital as an emergency will have AKI, which will prove fatal in just under a quarter of those cases.

But NICE believes between 12,000 and 42,000 of those fatalities could be prevented if patients were given high quality treatment.

A report from the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published in 2009 found only half of all patients with AKI had received good care.

That proportion dropped to a third for those who had developed AKI while in hospital.

The report suggested a third of patients suffered due to inadequate investigations, including a failure by staff to carry out basic checks.

Recognition of symptoms among hospital staff was also found to be 'poor', with some patients not always referred to kidney specialists in time and drug prescribing errors also contributing to some deaths.

Under the new NICE guideline, NHS staff are told to measure serum creatinine levels, which are a marker of kidney function, in patients with existing conditions such as heart failure, liver disease, diabetes, a history of kidney problems or blood poisoning.

It also calls for close monitoring of patients taking common drugs such as ibuprofen, ARBs or ACE inhibitors for high blood pressure and other conditions, or diuretics, as these can have an impact on kidney function.

Copyright Press Association 2013