Medicines highlighted as risk factor in AKI guideline
Healthcare professionals have access to a new clinical guideline to help them detect and prevent acute kidney injury (AKI), which is seen in up to 18 per cent of all people admitted to hospital.
The guideline, published today (28 August 2013) by the National Institute for Health and Care Excellence, recommends that healthcare professionals investigate for AKI by measuring serum creatinine levels in people with acute illness if one of a number of risk factors is present. One of the factors noted is that patients are using drugs with nephrotoxic potential within the past week, especially if the patient is hypovolaemic (has a reduced circulating blood volume).
These drugs include non-steroidal anti-inflammatory drugs (NSAIDs), aminoglycosides, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and diuretics.
Other factors noted, include: the patient has heart failure, liver failure, diabetes, a history of acute kidney injury, reduced urine output, neurological impairment, hypovolaemia, sepsis, or is aged 65 years or over.
Coral Hulse, a nurse consultant at the Mid-Cheshire Hospitals who helped develop the guideline, said: "Monitoring fluid intake and how much urine is passed is vital in the war against acute kidney injury as is monitoring the medication the patient takes and checking results as soon as they are available."
NICE estimates that around 12,000 cases of AKI are partially or fully preventable.
Earlier this year, a BMJ study found that patients taking a high-potency statin compared with patients taking a low-potency statin have an increased risk of admission to hospital for AKI (PJ 2013;290:326).
Read more about the management of AKI here.
Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11124836
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