Reducing harm from acute kidney injury and developing a sick day rule

WestRenal and Urogenital
Start Date: 31 May 2016

Background

Kidney function can suddenly drop when someone becomes unwell, for example when they get an infection or have diarrhoea and vomiting. This is particularly likely when the person is elderly, has other medical problems or is taking certain medication. This drop in kidney function is called acute kidney injury (AKI) and is associated with a higher chance of being admitted to hospital and spending longer in hospital.

One in four patients admitted to hospital with AKI do not survive and those that do survive are often left with some long term kidney damage as a result. Expert opinion suggests that something as simple as stopping certain medications during illnesses may reduce the chance of AKI. This approach is often referred to as giving patients a sick day rule and has become standard practice for some other conditions such as diabetes. However, there are no studies to prove that this protects patients from AKI and other experts warn that stopping these medications may cause harm in other ways.

Study aims

This study is a systematic review of existing academic literature, to assess the current evidence relating to patients at risk of acute kidney injury (AKI) temporarily stopping certain medication, and developing a sick day rule intervention.

Contact 
Dr Fergus Caskey
mdfjc@bristol.ac.uk