Post-acute kidney injury care: management of patients who have had an episode of care complicated by AKI in Bury CCG

What were we trying to do?

This project aimed to implement and evaluate novel interventions to manage patients who have had an episode of care complicated by Acute Kidney Injury (AKI).


Our key strategic objectives included:

  • To implement measures to improve the management of post-AKI care in the primary care setting;

  • To understand the process of implementation;

  • To measure the impact of the improvement work;

  • To provide a platform for potential larger scale evaluation, by building on the currently limited evidence base;

  • To inform the design of a sustainable model of care to support better medicine management in primary care.


Why was it important?

AKI is a syndrome which is common, harmful and costly. One in five emergency hospital admissions are associated with AKI, and it also increases the frequency, intensity and duration of hospitalisation.  

Furthermore, AKI is associated with significantly worse short and long-term outcomes including; higher risk of a further episode of AKI; increased risk of chronic kidney disease (including end stage renal disease); higher mortality rates both in the immediate and longer term. This project will focus on improving the management of post-AKI patients in general practice, to lessen the risk of recurrence.


What have we done so far?

We have:

  • Undertaken three annual audits of coding and follow-up management of patients who’ve been discharged from hospital with AKI, and fed the results back to the GP practices and the CCG

  • Supported GP practices via educational events to help them develop action plans for the management of patients with AKI

  • Qualitatively evaluated the process of implementing AKI alerts in primary care, exploring barriers and enablers to change


What will we do next? 

We will disseminate the findings from our mixed methods evaluation, using quantitative and qualitative research methods:

    • Quantitative: investigating the effect of the audit and feedback on processes of care, service delivery, patient outcome measures and costs.

    • Qualitative: exploring the processes of managing patients with AKI in primary care (interviews with commissioners, GPs, practice nurses, practice managers and pharmacists).


Who are we working with?

NHS Bury Clinical Commissioning Group

Pennine Acute Hospitals NHS Trust



Downloadable Recources


More information

For further information, please contact Susan Howard (Programme Manager)

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