Nephron
Clinical Practice: Original Paper
One Year's Observational Study of Acute Kidney Injury Incidence in Primary Care; Frequency of Follow-Up Serum Creatinine and Mortality RiskBarton A.L.a · Mallard A.S.a · Parry R.G.bDepartments of aClinical Chemistry, and bNephrology, Royal Cornwall Hospital, Truro, UK
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Article / Publication Details
Received: December 12, 2014
Accepted: April 21, 2015
Published online: June 19, 2015
Issue release date: July 2015
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3
ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)
For additional information: https://www.karger.com/NEF
Abstract
Background/Aims: Publications on acute kidney injury (AKI) have concentrated on the inpatient population. We wanted to determine the extent of AKI in the community, its follow-up and patient impact. Method: Primary Care creatinine results for May 2012-April 2013 from Cornwall, United Kingdom, were screened for AKI. Results: Over 12 months, 991 AKI episodes were identified (0.4% of all Primary Care creatinine requests); 51% were AKI1, 29% AKI2 and 10% AKI3. Of these, 51% AKI1s, 72% AKI2s and 77% AKI3s had a repeat creatinine requested within 14 days as per National Institute for Health and Care Excellence (NICE) guidelines. Admissions (May 2012-July 2013) were identified on 46% AKI1s, 58% AKI2s and 65% AKI3s (p < 0.05). The median time from AKI identification to hospital admission was 33 days for AKI1, 12 days for AKI2 and 1 day for AKI3 (p < 0.05); with a median length of stay of 2, 4 and 7 days, respectively (p < 0.05). The 90-day mortality from AKI identification for the admitted patients was 12% AKI1s, 20% AKI2s and 27% AKI3s (p < 0.05) vs. 11, 21 and 65% (p < 0.05) for those that were not admitted. There was no significant difference in mortality for admitted patients vs. non-admitted patients, except for the AKI3s. Conclusion: AKI is associated with increased admission and mortality rates; although a large proportion of patients had repeat creatinine testing within 14 days, there was still a significant number with delayed follow-up. Education within Primary Care is required on how to prevent, identify, follow-up and manage AKI.
© 2015 S. Karger AG, Basel
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Article / Publication Details
Received: December 12, 2014
Accepted: April 21, 2015
Published online: June 19, 2015
Issue release date: July 2015
Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 3
ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)
For additional information: https://www.karger.com/NEF
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