The first results from the Tackling AKI study were presented in the ‘late breaking clinical trials’ poster session at the American Society of Nephrology conference in New Orleans, USA.
Tackling AKI was a pragmatic clinical trial, funded by the Health Foundation, which tested the effectiveness of a complex intervention (AKI e-alerts, AKI care bundle and tailored education programme) across five UK hospitals. The study used a cluster randomised stepped wedge design that made the study the most robust assessment of this type of AKI intervention to date, allowing greater power to differentiate between effects of the intervention versus independent changes over time. In addition, data collection and analysis were performed independently of core project teams by the UK Renal Registry and the University of Bradford, also adding to the validity of the study.
Over 24,000 patients were included in the study. Results showed that the intervention resulted in improvements in delivery of care, improved AKI detection, shorter duration of AKI and a reduction in LoS, but did not alter 30-day AKI mortality.
Chief investigator, Dr Nick Selby said: “The importance of these results is that they provide the most robust evidence to date for an approach to reduce harm associated with AKI, and they support the work of the national AKI programme (Think Kidneys). Although mortality did not change in this study, important benefits for patients were seen. In addition, a reduction in hospital LoS may translate into significant health economic benefits for the NHS, particularly when considering that AKI occurs in as many as 10% of hospital admissions.”
Further results are still to come, both in the form of the publication of results in peer-reviewed journals and in terms of the qualitative analysis, which will explore the fidelity of the intervention and barriers and enablers to implementation across the five sites.
View the initial results that were presented at ASN.