The acutely unwell patient with diabetes; thinking kidneys in primary and secondary care
Last month, I was delighted to introduce the first ever session at the Diabetes UK conference on Acute Kidney Injury (AKI) and Diabetes, initiated by the British Kidney Patient Association.
Following the launch of the first NICE AKI guidelines in 2013 (to which I was pleased to be able to contribute as a lay advisor), NHS England, under the guidance of Dr Fluck created a Think Kidneys Programme to address the avoidable harm arising from lack of awareness of AKI. One of my findings from those guidelines was that there was little or no information out there for people with or at risk of AKI.
In 2014, NICE brought out some updated CKD guidelines – again I was pleased to be a lay advisor to these, which contained a number of educational recommendations.
These were:
- Offer people with CKD education and information tailored to the severity and cause of CKD, the associated complications and the risk of progression.
- When developing information or education programmes, involve people with CKD in their development from the outset.
They also, for the first time, included a recommendation to warn people with CKD about the risk of AKI.
The latest figures from the UK Renal Registry show nearly 60,000 people with kidney failure are being treated with dialysis or transplantation, and for 27% of new patients the cause of their kidney failure was diabetes, up by 5% from 2009. Survival for people with diabetes and renal failure is lower than for others with renal failure.
The Think Kidneys programme is making excellent steps in both primary and secondary care to prevent AKI, especially in people who are particularly at risk such as those with CKD, diabetes and/or in care homes.
The BKPA is equally supportive of the programme, and has worked hard to produce the missing patient resources, for those who have had AKI (and don’t want to get it again!) and to help people at risk to protect their kidneys from AKI, and for those with CKD and whose kidneys have failed.
The 60,000 people I discussed are not however the only target for this programme – there are millions with CKD and millions with diabetes. It is caring for those and especially the acutely ill person that the education in the session was aimed at.
The speakers were:
Dr Richard Fluck, former National Clinical Director for Renal, kidney doctor at Derby Teaching Hospitals NHS Foundation Trust introduced the secondary care perspective. Richard’s slides can be accessed here.
Dr Daniel Lasserson, GP and Associate Professor and Senior Interface Physician Oxford University Hospitals NHS Foundation Trust gave a view from primary care. Dan’s slides are here.
The small but perfectly formed audience came from both areas and were clearly very committed to the topic.
We would like to thank Diabetes UK for enabling the session and the Think Kidneys team for supporting it, and of course Richard and Dan for their excellent talks.
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.