NICE CG169 Acute Kidney Injury
NICE has produced a clinical guideline on the prevention, detection and management of acute kidney injury, formally known as acute renal failure or kidney failure. It emphasises that early intervention is a key factor to reduce mortality rate.
Acute kidney injury is seen in 13-18% of acute hospital admissions, predominantly affecting older patients. The mortality rate is approximately 25-30%, but early intervention can save lives and reduce morbidity. Detection of acute kidney injury is done by measuring serum creatinine and a fall in urinary output is also a sign. Patients with cognitive or physical impairment may not drink sufficient fluids, which must be addressed to prevent hypovolaemia.
Some drugs have nephrotoxic side-effects including:
NSAIDS, e.g. ibuprofen
ACE inhibitors, e.g. enalopril
Angiotensin II receptor antagonists, e.g. losartin
Diuretics, e.g. bendroflumethazide
Further information and guidance on managing acute kidney injury is available: http://www.nice.org.uk/CG169
Photo taken from here. No changes made.