The Chronic Kidney Disease HIT report on their work in 2017-18

Dr Udaya Udayaraj and Dr Fergus Caskey give an update on the work of the Chronic Kidney Disease Health Integration Team (CKD HIT) over the last year.

Chronic kidney disease (CKD) is a long-term condition that can increase the risk of heart disease or sudden deterioration in kidney function. The Chronic Kidney Disease Health Integration Team (CKD HIT) is a team of clinical staff, researchers and patients, working together to improve outcomes and care pathways for patients with kidney disease.

Our telephone clinic pilot for kidney transplant patients ended in July 2017. This quality improvement (QI) project found that using telephone clinics is deliverable, safe and well received by patients. Part funded by the West of England Academic Health Science Network (AHSN), the teleclinics improved patient experience and productivity, and reduced the environmental impact of travel. We are extremely grateful to the 168 patients that took part, and GP practices that helped conduct blood tests.

Our working group on acute kidney injuries (AKIs) has continued to meet and develop shared approaches to preventing and managing AKIs. These injuries are estimated to affect 13-18 per cent of people admitted to hospital and can range from minor loss of kidney function to complete kidney failure. To help address this locally, we developed a care pathway for the management of AKIs in primary care, which is being used across the region. We have also launched e-learning modules across North Bristol NHS Trust to help with identification and prevention of AKIs.

We also collaborated with NIHR CLAHRC West to investigate temporarily stopping some medicines to prevent acute kidney injury for unwell patients. Our evidence review, published in BMJ Open in April 2017, has shown that more research is needed on the effect of stopping taking medicines on kidney function in people who aren’t in hospital, when they are unwell. We used Clinical Research Datalink data to analyse the risk of AKI when people start taking renin angiotensin aldosterone system blockers. We expect to publish results shortly.

Finally, we thank Dr Uday Udayaraj for his leadership of the CKD HIT. Uday is moving to Oxford after leading the HIT with energy and tenacity for several years. Dr Fergus Caskey, Medical Director of the UK Renal Registry, became HIT Director on 1 April 2018 and will work with the team to refresh projects and priorities for the year ahead.