A couple of years ago I was admitted to hospital with flu-like symptoms and possible dehydration; before I fainted I recall asking what the team were checking me for. ‘Acute kidney injury’, came the reply, which both reassured but also worried me. It reassured me because the very fact I was being checked meant I was in the right place, but it worried me as my role on the NICE guideline development group for acute kidney injury meant that I understood more than most people what that could mean. It was also the very first time anyone had ever spoken to me about my risk of acute kidney injury, despite a long history of chronic kidney disease (CKD), eventually dialysis and then transplantation.
Over the years I have become not just expert in my own condition, but I’ve also had the privilege to work with many people with CKD through my various roles nationally and locally. No-one ever talked about acute kidney injury and yet people with kidney disease, many of who have become experts in their own care, are at very high risk of developing it. And if this is how it is for people like me, you may start to grasp why the general population will not have any idea whether they or indeed a relative, could be at risk or what they can do about it anyway.
So, what is acute kidney injury and what can you do to avoid it?
When the kidneys suddenly stop working properly, often occurring when someone is being treated as an emergency, perhaps because they have a major health problem such as pneumonia or some types of cancer, this is acute kidney injury. While that major problem or infection is being focused on by healthcare specialists, the kidneys can be really struggling. This may be because of issues such as dehydration, an obstruction or medicines which are normally appropriate but which should be suspended during the emergency.
Many people make a good recovery from acute kidney injury, but a significant number do not. So there’s a really strong case for raising awareness of acute kidney injury because in many cases it can be avoided. That’s what the ‘Think Kidneys’ programme is all about.
Of course there are practical things people can do to try to help themselves and safeguard their kidneys, and here are a couple of suggestions:
- Drink plenty, and if you have a long term condition like heart disease, diabetes, liver or kidney disease and start to become dehydrated for a prolonged period of time, ask your doctor or nurse for advice
- Medicine/tablets. If you are buying over the counter medications, tell your pharmacist if you have a long term condition
As many people don’t know that acute kidney injury could affect them, if you or a relative go into hospital with an acute illness this is what I would be asking
- Has their kidney function been checked?
- Have their medicines have been reviewed?
- Are they drinking and passing urine regularly ?
Many hospitals do the right thing, but acute kidney injury is not always detected and treated in the most effective way, there’s no consistent approach and good practice is not always shared.
I want us to be in a position where everyone who turns up at hospital or in the community who could be at risk of acute kidney injury will consistently be checked so that it can be prevented where possible. I want to see a situation where it becomes habit to think kidneys, with the right education, as much for healthcare professionals as for patients, to make it easier to do so.
That’s why I’m part of the ‘Think Kidneys’ programme and co-chairing the risk group. And that’s why the British Kidney Patient Association is supporting me to commit some of my time to this work. The people we support every day know all too well the impact of kidney failure on their lives and their families. We too have a role to play in the education work and in speaking up for patients.
Think Kidneys is a big programme which needs to make a measurable difference to outcomes for patients. By bringing together some of the right people we have a good opportunity to do so, and I say it’s about time too.
By the way, with reference to the story at the top, it wasn’t acute kidney injury and I was fine within a few days. Thanks for asking and thanks also to the NHS.
Fiona Loud @fionacloud
British Kidney Patient Association
About the BKPA
The British Kidney Patient Association aims to reach and improve the care and daily quality of life for everyone affected by kidney disease.
We are the leading grant-giving charity supporting kidney patients in the UK.
- Educating and informing patients, the public and healthcare professionals about kidney disease.
- Campaigning to improve the lives and choices of kidney patients.
- Funding healthcare professionals, projects and services.
- Funding patient-centred research.
www.britishkidney-pa.co.uk @The_BKPA
Fiona Loud
In her student years (‘a long time ago’), Fiona studied a BA (Hons) English at Southampton University. However, after her student years Fiona pursued and continues to pursue her interest in healthcare. Fiona’s roles at present is Policy Director for The British Kidney Patient Association, and co-chairs the Risk workstream for the Acute Kidney Injury National Programme.
Fiona is Chair of the UK Renal Registry Patient Council, the West Herts Hospital Organ Donation committee and is vice chair at The Local Kidney Patients Association at Lister Hospital. In her spare time (though we find it hard to believe she has any!) Fiona takes things at a bit more relaxed pace, and enjoys activities such as sleeping, reading, and going for long walks with the family dog, Ollie.