Open AccessImproving recognition and management of acute kidney injury
Author(s) -
A Tsui,
C Rajani,
Roshni Doshi,
De Wolff J,
RC Tennant,
Neill Duncan,
Henry Penn
Publication year - 2014
Publication title -
acute medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.14
H-Index - 12
eISSN - 1747-4892
pISSN - 1747-4884
DOI - 10.52964/amja.0357
Subject(s) - medicine , acute kidney injury , nephrotoxicity , medical prescription , creatinine , intensive care medicine , emergency medicine , prospective cohort study , urine , urinary system , kidney , pharmacology
Acute kidney injury (AKI) is currently suboptimally recognised and managed in the UK, despite its association with significant patient morbidity, mortality and consequent implications for healthcare economics. Our prospective study, performed in a large urban London hospital, demonstrated that the introduction of a specially designed care bundle can significantly improve documentation of baseline creatinine, assessment and optimisation of fluid status, performance of urine dip, withholding of nephrotoxic drugs, appropriate monitoring of urine output, prescription of renal drug doses, and appropriate consideration of a renal ultrasound and urinary protein-creatinine ratio. Improved compliance of appropriate investigations and initial treatments translated to decreased requirement for intensive care admission and a trend towards shorter length of stays.