A role that has transformed the care of patients with acute kidney injury

The role of acute kidney injury (AKI) specialist nurse was set up as part of a bespoke service within Walsall Healthcare NHS Trust, acting as a ‘spoke’ for renal services in the area. The hub service offers dialysis, and provides chronic kidney disease (CKD) and renal clinic outreach both locally and via the hospital, which is located 6 miles away. Locally, the service was previously provided by two consultants who provided nephrology and acute medical cover, and offered AKI advice and support to ward doctors.

The service expansion, which included the addition of my role, was developed in order to provide support for all patients diagnosed with stage 3 AKI within 12 hours of diagnosis. The service provides intervention, advice, guidance and follow-up, and facilitates early discharge with appropriate follow-up, either in the community or in the outpatient clinic setting. The follow-up service includes patient review, identification of reversible causes, a medicines review, appropriate prescribing of ongoing medication to avoid further complication from kidney injury or CKD. Appropriate referrals would be made at this visit, including investigations required, for biopsy, dialysis education, dialysis access formation or conservative management.