UKRR AKI report released today: a report on the nationwide collection of AKI warning test scores from 2018

Today the UK Renal Registry (UKRR) and the Renal Association (RA) publish a ground breaking national report on acute kidney injury (AKI), representing a major milestone for the clinical community. The report, which is the first of its kind, is based on the all AKI warning test scores automatically forwarded from reporting laboratories and highlights AKI incidence rates, mortality rates, cost and variation of AKI in England.

  • The report is a comprehensive summary of monthly AKI data returns from 2018 to the UKRR from laboratories’ results of AKI warning stage blood tests. Almost 90% of labs serving NHS providers in England submitted data. The data are linked to HES and ONS and the results are described by CCG, by AKI stage and where the warning test was generated – acute or community setting.
  • The cost of AKI is high to the NHS, trusts, and the health economy as well as to the individuals and their families who suffer the consequences. The cost of AKI to the NHS is estimated to be up to £620m each year
  • The key facts are:
    • 87% of laboratories in England submitted data generating 1.5m AKI alerts in 500K (approx.) people representing over 560K episodes of AKI during 2018.
    • The unadjusted rate of AKI episodes in England was 12,300 per million population with a significant variation between CCGs – 5,300 to 20,700 per million population.
    • 71% of people with an AKI episode had a hospital stay – 39% with community acquired, 32% with hospital acquired AKI. Median length of stay was 12 days in hospital and was more than double in hospital acquired than in community acquired AKI.
    • 18% of people with an AKI episode died within 30 days of the first alert. This increased with peak AKI stage – 13% for stage1, 29% for stage 2 and 33% for stage 3.
    • Mortality within 30 days of hospital-acquired AKI was 24%. Mortality at 30 days was higher in those from lower socio-economic background and in winter (January to March).

We are asking commissioners and providers to use the information provided by the report to work to understand the variation in incidence rates of AKI across England. They should drive service improvement to make changes either to elements of care for people with AKI and to improve reporting of warning test results where data provided is incomplete and where some labs are not reporting at all.