EP 499 Assessing Acute Kidney Injury Management in General Surgical Patients in a Busy District General Hospital

Aims

Acute kidney injury (AKI) increases morbidity, mortality and length of stay. Early identification and assessment can help lead to reducing the effect of the AKI.

This audit aimed to assess our compliance with the National Institute for Health and Care Excellence (NICE) and local guidance.

Methods

A retrospective audit of AKI in general surgical patients between 05/07/25 and 28/09/25 was conducted against four standards NICE (NG148): Urine dipstick performed in all patients, Renal ultrasound within 24 hours unless a clear cause of AKI is apparent, Documented review of medications and fluid balance, and Follow-up plan after discharge. Data was extracted from medical notes and local systems.

Results

20 patients developed AKI. 6/20 (30%) had a documented review by a member of the general surgical team after diagnosis. 2/20 (10%) were reviewed by a senior member of the team (registrar or consultant). 4/20 (20%) had a documented medication review, with 4/20 (20%) having a documented review of fluid balance. 0/20 (0%) had urine dipstick results documented. 2/20 (10%) had a renal ultrasound performed. 7/20 (35%) had their AKI diagnosis mentioned on their discharge letter, with 5/20 (25%) having specific AKI follow-up.

Conclusion

Performance against AKI standards could be improved. Further work is required to develop our AKI pathway in general surgical patients. A strategy has been devised and is currently being implemented.