Acute Kidney Injury Clinical Trial
Official title:
Acute Kidney Outreach to Reduce Deterioration and Death (AKORDD) - A Pilot Study to Look at Enhancing Patient Care, Improving Patient Outcomes and Reducing NHS Costs
The study pilots an outreach service for Acute kidney injury (AKI) patients, based on electronic alerts. Using the alerts we will contact the primary clinician caring for the patient with AKI in the Intervention group. The study has a control group of patients receiving good standard care, but without Outreach. The aim is to reduce morbidity and mortality in the syndrome, and also to reduce healthcare costs.
Lay summary:
About one in six hospital inpatients suffer Acute Kidney Injury (AKI), also called acute
renal failure. About a third of patients with AKI die. The large majority of patients with
AKI are managed by doctors who are not kidney experts. Effective AKI advice and treatments
are available but not currently integrated into routine care. A recent National review of the
care of patients who died from AKI showed poor management of many patients. Early diagnosis
of AKI can avoid complications, dialysis (which affects the quality of life of patients, and
is costly) or death. AKI is diagnosed by a change in a blood test. We have developed computer
software to diagnose AKI earlier. It sends a warning or 'Alert' about the test to our team of
kidney experts. We will further develop the settings of the Alert system. It needs to send an
Alert for the right patients. We will also study the best way to make clinicians pay
attention to their patients who are developing AKI. When our expert Outreach team receive an
Alert, they will call the doctor or nurse looking after the patient with AKI. We will advise
on the best treatment for that patient, to reduce their risk of death, dialysis and other
complications. We will do a pilot study in one large hospital, to further develop the system,
and check it reduces the risk of death or complications from AKI. We will use this work to
develop a larger trial of this new system of care for patients with AKI in different
hospitals. This will convince the wider NHS of the need to change, and show how to prevent or
reduce AKI. Ultimately we aim to improve patients' lives by reducing avoidable death and
illness from AKI , and also save the NHS money.
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