All information is correct at time of printing and is subject to change without notice. The Devon Formulary and Referral Website is not in any way liable for the accuracy of any information printed and stored by users. For the most up-to-date information, please refer to the website.
Acute Kidney Injury (AKI) was previously known as acute renal failure, and means a sudden reduction in renal function. It is associated with increased mortality, can have many different underlying causes, and is not a result of traumatic injury.
Significance in Primary Care
Related Clinical Referral Guidelines:
Patient factors:
Clinical factors:
It is common to see patents with an increase in serum creatinine and a long gap between current value and baseline. In this situation consider:
Red Flags - discuss with Nephrology
Not every patient with a rise in creatinine will have a recent baseline to compare. The result has to be taken in clinical context, and if the situation allows a repeat creatinine (after 48-72 hours) may help distinguish dynamic changes in serum creatinine from a more stable CKD picture.
If so this should increase clinical concern.
Increasing severity correlates with worse outcomes. AKI stage 3 should be managed in secondary care.
Is there obstruction / intrinsic renal disease. Dip the urine.
Avoid / correct dehydration
Medication review, consider stopping
See here for a more comprehensive list regarding optimising medication in patients with AKI
Early review with repeat Renal Biochemistry (Na, K, Creatinine but don't routinely measure Urea)
Code the occurrence of an AKI episode and if secondary to medication then code as a Drug sensitivity
e-Referral Service Selection
NHS England AKI Programme (Think Kidneys)
NICE Acute kidney injury: prevention, detection and management
Clinical guideline [CG169] Published 2013
This guideline has been signed off by the Pathology Optimisation Clinical Group on behalf of NHS Devon.
Publication date: April 2017