Guidance to help standardise the detection and alerting of acute kidney injury (AKI) in England is now available to download.  

GIRFT has formed an AKI working group with the Association for Clinical Biochemistry and Laboratory Medicine (LabMed), the UK Kidney Association (UKKA), and the UK National External Quality Assessment Services (NEQAS) to carry out a national survey, write a research paper and develop the guidance.  

Acute Kidney Injury (AKI) is a common clinical syndrome with high mortality and morbidity, affecting as many as 20% of hospital admissions. Survivors are at a higher risk of later developing chronic kidney disease (CKD). The estimated annual cost of AKI in England is approximately £1bn or 1% of the NHS budget.  

NHS England issued a Patient Safety Alert in 2014 mandating all acute trusts in England to implement AKI warning stage results using a standardised algorithm. In 2021,  

GIRFT’s renal and pathology workstreams published their national reports, both noting significant variation in AKI reporting and use of the algorithm in laboratories.  

The AKI working group was formed and a survey of 91 laboratories captured information on the AKI detection and alerting process nationwide. A subsequent research paper was published in 2023, identifying laboratory practices that potentially contribute to the unwarranted variation in the reporting of AKI in the England and developing 10 suggested best practice recommendations to help remedy the situation.  

GIRFT’s latest guidance relists those suggested best practice recommendations, supporting lab professionals and clinical biochemists, renal medicine specialists and nephrologists, primary care practitioners, quality improvement teams and Laboratory Information Management System (LIMS) providers (which install and maintain AKI algorithms) to ensure consistent implementation of the NHS England AKI mandated algorithm.