MTP1.16 Assessing acute kidney injury management in general surgical patients

Abstract 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 and local guidance. Methods A retrospective audit of AKI in general surgical patients between 01/12/23 and 01/01/24 was conducted against four standards: 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 22 patients developed AKI. 13 patients (59.1%) had a documented review by a member of the general surgical team after diagnosis, and seven were reviewed by a senior member of the team (registrar or consultant). Four (18.2%) patients had a documented medication review, with nine (40.9%) having a documented review of fluid balance. Four (18.2%) patients had urine dipstick results documented, and one patient had a renal ultrasound performed. Two patients had their AKI diagnosis mentioned on their discharge letter, with one patient having specific AKI follow-up. Conclusions Performance against AKI standards was poor. Further work is required to develop our AKI pathway in general surgical patients. A strategy has been devised and is currently being implemented.