Call for kidney checks to save thousands of lives

Thousands of patients are dying needlessly every year from kidney problems that could be treated, says the National Institute for Health and Care Excellence (Nice).

Nice says between 12,000 and 42,000 deaths could be prevented every year if patients received the best possible care.

Around 100,000 cases of acute kidney injury (AKI) – previously called acute renal failure – could also be stopped across England with simple checks, such as ensuring patients are not dehydrated.

Patients also have a part to play by ensuring that they drink plenty of water and regularly visit the toilet.

Costs

AKI costs the NHS between £434m and £620m a year, more than it spends on breast, lung and skin cancer combined. It involves a loss of kidney function that can develop very quickly.

It can occur in people who are already ill with conditions such as heart failure or diabetes, those admitted to hospital with infections, and patients who have had major surgery.

If the condition is not picked up quickly it can lead to the kidneys shutting down, which can cause severe illness and death.

Between 262,000 and one million people admitted to hospital as an emergency will have AKI, of whom just under a quarter will die.

Preventable deaths

Of these, up to 42,000 deaths could be prevented if patients received good treatment, according to Nice.

A 2009 report found only half of patients with AKI had received good care, dropping to just a third of those who had developed it while in hospital.

A third of patients suffered due to inadequate investigations, including health staff not carrying out “simple” and “basic” checks.

‘Cinderella condition’

Dr Mark Thomas, who chairs the group that is developing the new guidelines, said: “AKI has been something of a Cinderella condition in the past both within healthcare and in the public perception, yet it kills more people than any of the common cancers.

“In the past, the care for this condition has not always been uniformly good, partly because the patients have tended to present to a range of non-specialists who may have been unfamiliar with the best prevention and treatment of the condition.”

But Dr Thomas said the NHS had made progress and would make further strides by adopting the guidelines.

‘Huge problem’

Professor Mark Baker, director of the centre for clinical practice at Nice, said: “Acute kidney injury is a huge problem for the NHS.

“This new Nice guideline aims to raise awareness among healthcare professionals to recognise and treat the condition early and focuses on prevention, recognition, treatment and timely access to specialist services for all.”

Fiona Loud, director of the Kidney Alliance, said: “Patients also play a role in the prevention and detection of AKI. Make sure you drink plenty of water and are regularly going to the toilet are ways to avoid the condition.”

More than half of people who develop AKI are over the age of 65.