AsterAKI

Researchers from the University of Manchester are looking for patients or carers to be involved in a study looking into the quality of post-discharge care of people who have suffered acute kidney injury (AKI) and been in hospital as a result.

Background information
Kidneys are essential for our health. They have a number of vital roles. These include filtering our blood and getting rid of waste and excess water by converting it into urine.
“Acute Kidney Injury” (AKI) refers to a circumstance when the kidneys suddenly stop working properly within hours or a few days. There are many reasons why AKI can occur.

The most common cause is when our body becomes short of salt and water, such as when people become dehydrated from diarrhoea and vomiting. AKI is common, harmful and costly. A recent report for England showed that AKI affects nearly half a million people a year. It affects 1 in 7 people admitted to hospital unexpectedly. It is more common among people who are frail or who live with multiple health problems such as diabetes and heart failure.

Why is this research important?
We have shown that AKI remains an important and overlooked health problem for people even after they recover and go home from hospital. One in 5 people will need to be admitted to hospital again as an emergency within a month and 1 in 3 people within three months. If someone has had AKI they are also more likely to develop lasting kidney damage known as chronic kidney disease (CKD). Over the past 10 years, tackling the harm related to AKI has been a major priority for the NHS. However, most research and quality improvement activities have taken place in hospitals. Research is now needed on how to ensure high-quality person-centred care for people affected by AKI following discharge from hospital.

About ASTERAKI
As a starting point, we have already used robust research methods to develop national standards to improve care for people affected by AKI. These include:
(1) Helping people understand how to keep their kidneys healthy when they become unwell.
(2) Supporting people with their medicines, such as restarting important drugs for people with heart failure.
(3) Ensuring a timely review by a clinician
(4) Carrying out tests at the right time to ensure that we are quick to identify people with recurrent or lasting kidney problems.

How can you help?
Our NIHR funded research study will involve three related tasks:

First, we will analyse large numbers of medical records to assess the current state of care for people leaving hospital following AKI. We will check whether care is being delivered according to national standards, try to work out why care sometimes fails to meet these standards, and identify areas where we can improve future care.

Second, we will talk with people to learn from their experiences of care following AKI. With people’s permission, we will review their medical records and interview others involved in their care, such as their GP, nurse, pharmacist or member of hospital staff. Where appropriate, we will also talk with family members who provide support.

Third, we will hold workshops with patients and care providers, where we will discuss findings from our analyses of the interviews and medical records. Through shared learning, we will develop practical recommendations to improve the quality of post-discharge care.

In partnership with patients, carers and professionals, our research aims to:
(1) strengthen national guidelines
(2) help improve resources that support person-centred care
(3) develop reliable ways of measuring high-quality care for people leaving hospital after AKI
(4) guide quality improvement across the health service.

If you have experienced AKI, or have cared for somebody who has, and you are interested in being involved in this research, or would like some further information about what it may involve, please contact either Holly Loughton (holly.loughton@kpin.org.uk) or Dr Tom Blakeman (tom.blakeman@manchester.ac.uk).

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