PMID- 37218087 OWN - NLM STAT- MEDLINE DCOM- 20231115 LR - 20231124 IS - 1758-1001 (Electronic) IS - 0004-5632 (Linking) VI - 60 IP - 6 DP - 2023 Nov TI - National recommendations to standardise acute kidney injury detection and alerting. PG - 406-416 LID - 10.1177/00045632231180403 [doi] AB - BACKGROUND: National Health Service England issued a Patient Safety Alert in 2014 mandating all acute Trusts in England to implement Acute Kidney Injury (AKI) warning stage results and to do so using a standardised algorithm. In 2021, the Renal and Pathology Getting It Right First Time (GIRFT) teams found significant variation in AKI reporting across the UK. A survey was designed to capture information on the entire AKI detection and alerting process to investigate the potential sources of this unwarranted variation. METHODS: In August 2021, an online survey consisting of 54 questions was made available to all UK laboratories. The questions covered creatinine assays, laboratory information management systems (LIMS), the AKI algorithm and AKI reporting. RESULTS: We received 101 responses from laboratories. Data were reviewed for England only - 91 laboratories. Findings included that 72% used enzymatic creatinine. In addition, 7 manufacturer-analytical platforms, 15 different LIMS and a wide range of creatinine reference ranges were in use. In 68% of laboratories, the AKI algorithm was installed by the LIMS provider. Marked variation was found in the minimum age of AKI reporting with only 18% starting at the recommended 1 month/28-days. Some 89% phoned all new AKI2s and AKI3s, as per AKI guidance while 76% provided comments/hyperlinks in reports. CONCLUSIONS: The national survey has identified laboratory practices that potentially contribute to unwarranted variation in the reporting of AKI in the England. This has formed the basis for improvement work to remedy the situation, including national recommendations, included within this article. FAU - Marrington, Rachel AU - Marrington R AUID- ORCID: 0000-0003-1045-8456 AD - Birmingham Quality (UK NEQAS), University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. FAU - Barton, Anna L AU - Barton AL AD - Clinical Chemistry, Royal Cornwall Hospital, Truro, UK. FAU - Yates, Alexandra AU - Yates A AD - Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK. FAU - McKane, William AU - McKane W AD - Sheffield Kidney Institute, Northern General Hospital, Sheffield, UK. FAU - Selby, Nicholas M AU - Selby NM AD - Centre for Kidney Research and Innovation, Academic Unit for Translational Medical Sciences, School of Medicine (Royal Derby Hospital Campus), University of Nottingham, UK. FAU - Murray, Jonathan S AU - Murray JS AD - Renal Unit, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK. FAU - Medcalf, James F AU - Medcalf JF AD - UK Renal Registry, Bristol UK. FAU - MacKenzie, Finlay AU - MacKenzie F AD - Birmingham Quality (UK NEQAS), University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. FAU - Myers, Martin AU - Myers M AD - Clinical Biochemistry, Royal Preston Hospital, Preston, UK. LA - eng PT - Journal Article DEP - 20230614 PL - England TA - Ann Clin Biochem JT - Annals of clinical biochemistry JID - 0324055 RN - AYI8EX34EU (Creatinine) SB - IM MH - Humans MH - Infant, Newborn MH - *State Medicine MH - Creatinine MH - England MH - *Acute Kidney Injury/diagnosis MH - Laboratories OTO - NOTNLM OT - AKI OT - Acute kidney injury OT - LIMS OT - algorithm OT - audit OT - creatinine OT - survey COIS- Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. EDAT- 2023/05/23 06:42 MHDA- 2023/11/15 06:42 CRDT- 2023/05/23 00:53 PHST- 2023/11/15 06:42 [medline] PHST- 2023/05/23 06:42 [pubmed] PHST- 2023/05/23 00:53 [entrez] AID - 10.1177/00045632231180403 [doi] PST - ppublish SO - Ann Clin Biochem. 2023 Nov;60(6):406-416. doi: 10.1177/00045632231180403. Epub 2023 Jun 14.