The war on acute kidney injury; the battle continues

Well, who’d of thought it, 12 months on from losing my blog-inity whilst participating in the first regional AKI event, I would be sat here writing another blog at the same event but having co-organised it! I’m proud (and ever so slightly smug) to say that lasts years blog holds CLAHRCs ‘most widely read blog’ record… thus far anyway. Must’ve been something to do with my rib-tickling ‘top blog tips’.

AKi conference 2016 - image 2

This year, Donal O’Donoghue (Renal Association President Elect) did a cracking job of setting the scene first thing, reflecting on the link between acute kidney injury and 20th century wars (the Imperial War Museum North being our impressive venue for the day). QUIZ TIME! What killed the majority of World War 1 soldiers? What about WWII soldiers? And what about now? (Answers at the bottom of the page – no cheating!). Fiona Loud (British Kidney Patient Association) nicely followed with the poignant tale of her own kidney injury journey, as well as painting the view from her professional perspective.

Then we were into the main sessions. These included presentations from speakers across the region and beyond, sharing their experiences and data from a whole host of different improvement projects all focussed around kidney care. A reoccurring theme that came out of many of the talks was the opportunities and challenges around the interface between primary and secondary care, a key area needing more focus going forward.

AKI Pt & Carer Engagement

So glad we put the moderated poster session on during the morning, it created a buzz, and opened up conversation and networking early on, which continued throughout the day. It’s so energizing to hear the swapping of notes and genuine interest in the learning from others. There was a real sense of ‘we’re making genuine progress here, but how can we do this even better?’

After a terribly nice lunch (thanks to our sponsors) overlooking Salford Quays, the Manchester Ship Canal and Media City; Rob Nipah (Salford Royal) stepped into the breach as an emergency presenter after we discovered an invited speaker couldn’t attend at the 11th hour. Uber respect to the Robster, and absolutely no points deducted whatsoever for his humble mid-presentation observation ‘I can’t believe this is going to so well actually!’

AKI conference 2016 - image 1

Gaining participation from every attendee at the concluding priority setting workshop was testament to the inclusive and enthusiastic mood of the day. It was notable that one of the common themes across all three areas explored (prevention/management/post-AKI care) was communication; in terms of the need for continued efforts to educate healthcare professionals, as well as raising patient/public awareness. This was also brought to the fore during one of prior breakout session ‘AKI care and communication strategies’, during which Bec Elvey (University of Manchester) presented the (soon to be released) key findings from the sick day guidance project conducted in Salford CCG, highlighting the challenges around patient communication and differing interpretation of the cards. In that session, Liz Lamerton (Salford Royal) presented on the novel pharmacist involvement in the Trust-wide AKI quality improvement initiative, highlighting the tangible benefit of a broad range of workforces contributing to kidney care; another key underlying theme, and future priority, coming out of the day.

So, we are done for another year. I’m really looking forward to following up links and ideas formed during the day, and watching the results of that collaborative activity shape up.

Blog by Sue Howard, CLAHRC GM Programme Manager

Thanks to Leonard Ebah (Central Manchester Foundation Trust), Tom Blakeman (NIHR CLAHRC GM/University of Manchester), Dimitrios Poulikakos (Salford Royal), Rob Nipah (Salford Royal) for helping shape the day, Michelle Davies (GM SCN) and Delphine Corgie (NIHR CLAHRC GM) for putting those ideas into action, and to all those who contributed to making this such a successful event


Question: What killed the majority of World War 1 soldiers?

Most died because of their injuries during the first world war. Although ‘war nephritis’ became a recognised condition, it fell back into obscurity after the war.

Question: What about WWII soldiers?

Post-traumatic renal failure became a major military issue during the second world war, with reports of ~42% of severely wounded soldiers affected, and high (96%) mortality rates. During the Korean and Vietnam wars, the importance of AKI (or acute renal failure as it was known then) was recognised, and incidence decreased due to better acute management, administration of intravenous fluids, and availability of dialysis.

Question: And what about now?

The greatest mortality cause in the current UK armed forces is cancer (27%). In-action deaths are largely associated with accidents. But there are now very few kidney-associated deaths/cases. In fact, in 2015, the UK Armed Forces were at a 73% less risk of dying of a disease-related condition compared to members of the UK general population.