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Clinical failings for urgent kidney patients

11th June 2009

A national inquiry has raised concerns over the standard of care offered to patients who develop emergency kidney problems in hospital.

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The National Confidential Enquiry into Patient Outcome and Death focused on patients in hospitals in England and Wales with acute kidney injury (AKI).

Of 564 patients who died, the inquiry discovered that half did not receive a good standard of care, particularly when it came to diagnosis.

Other issues highlighted in the report Adding Insult to Injury were delays in recognising AKI, blood poisoning, fluid loss and failure to carry out laboratory tests on deceased patients.

A quarter of cases were not seen by the relevant specialist.

Co-author Dr James Stewart said: “The majority of AKI patients were let down by clinical rather than organisational factors.

"In the past specialist clinical care has rightly focused on chronic kidney disease, but this has left acute kidney injury to be managed by non-specialists."

NCEPOD drew findings from 217 hospitals and found a lack of awareness among doctors of the risks of AKI, poor understanding of the condition and inadequate knowledge of how to manage it.

Health minister Ann Keen said she was seriously concerned that some hospitals were failing to follow the quality requirements in National Institute for Health and Clinical Excellence guidelines and the government’s strategy for kidney care contained in the National Service Framework for Renal Services.

Kidney Research UK said it was concerned over the report findings and called for appropriate basic training at graduate and post graduate level to identify any acute kidney injury.

 

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