Pilot aims to cut risk of acute kidney injury

The Yorkshire & Humber Academic Health Science Network (AHSN) is supporting a pioneering research programme at Mid Yorkshire Hospitals NHS Trust aimed at reducing the risk of acute kidney injury (AKI) in patients requiring CT or MRI scans.

laboratory assistant analyzing a blood sample

Currently patients who need a CT or MRI scan that also requires use of a contrast media or dye should have an up to date renal function test before they can have a scan. This is because the dye can cause acute kidney injury in some patients. If patients do not have an up to date renal function blood test, then it could mean their appointment has to be postponed, resulting in a potential delay in diagnosis as well as underuse of key NHS resources.

A team of radiographers and researchers at Mid Yorkshire Hospitals NHS Trust, with the support of the Yorkshire & Humber AHSN and the National Institute for Health Research Leeds Diagnostic Evidence Collaborative (DEC), is about to trial the latest point of care renal function blood test kits, comparing them to standard laboratory results.

This will ultimately allow for a redesign of the pathway so that patients can have a blood test at the same time as their appointment and the results will be immediately available to clinicians.

The programme will involve around 300 patients attending for standard outpatient blood tests. If the research programme is successful, it could result in new national guidelines being drawn up.

Carl Greatrex, Head of Innovation Adoption at Yorkshire & Humber AHSN, said: “We were able to identify three companies who were happy to provide the point of care testing kits and we have also funded part of the programme.

“This research could make a real difference to patient pathways. The Mid Yorkshire team has seen the potential that could be delivered and they are really committed to driving this important work forward.”

Dr Bev Snaith, a consultant radiographer from Mid Yorkshire, said: “Patients coming for a CT or MRI scan need a blood test to check for abnormal kidney function as the dye we inject can cause an acute kidney injury. If the point of care technology is shown to be effective, it can be tested in the imaging setting and hopefully reduce patient visits and scan waiting times.”

The three companies involved in the programme are: Abbott, Nova Biomedical and Radiometer.

It is estimated that the incidence of contrast induced acute kidney injury is approximately seven per cent, however it may be higher than 50 per cent if patients have risk factors such as chronic kidney disease, diabetes and nephrotoxic drugs.

Using point of care testing and ensuring all patients have an up to date renal function test at the time of their scans will help reduce this risk significantly.

The Yorkshire & Humber AHSN, through its Improvement Academy, hosted an Acute Kidney Injury Community Alert Roundtable meeting for GPs, Clinical Commissioning Groups (CCGs) quality leads and community staff.

The event, on Monday 18th July, provided attendees with an opportunity to learn about the latest evidence for community AKI management and treatment to improve outcomes for patients and to discuss barriers and ideas for improvement.

It was facilitated by Dr Sarah Harding, GP, Leeds South and East CCG, Dr Andrew Lewington, Consultant Renal Physician at Leeds Teaching Hospitals NHS Trust and Dr John Stoves, Consultant in Nephrology and General Medicine at Bradford Teaching Hospitals NHS Foundation Trust.

Dr Nick Selby, Renal Physician and Associate Professor of Nephrology at the University of Nottingham, Dr Ian Scott, a Nephrologist from Doncaster and Dr Mike Bosomworth, a Clinical Biochemist from Leeds, were guest speakers.