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Podcast - Kidneys on the Edge (Part 2): Managing AKI
- 2024/11/27
- 再生時間： 11 分
- ポッドキャスト
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サマリー
あらすじ・解説
The video version of this podcast can be found here: · https://youtu.be/vETTV_AmatYThe previous episode on AKI covering the diagnosis, investigations and recommendations on the use of contrast media can be found here:· https://youtu.be/k6amIFy84BcThis episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through the NICE guideline on acute kidney injury, NG148, focusing on what is relevant to Primary Care only, covering the management recommendations by NICE, and the Primary Care flowchart on AKI by Barnsley Hospital NHS Trust and King’s College Hospital NHS Trust. You can find links to them in the description below. If you have not already done so, I recommend that you check the previous episode on AKI covering the diagnosis, investigations and recommendations on the use of contrast media. I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The links to the guidance covered in this episode can be found here: Acute kidney injury: prevention, detection and management (NG148):· https://www.nice.org.uk/guidance/ng148The 1-page visual summary on assessing the risk of acute kidney injury in adults having iodine-based contrast media: outpatient, non-urgent inpatient and community settings:· https://www.nice.org.uk/guidance/ng148/resources/visual-summary-pdf-13551376429The algorithm for early identification of acute kidney injury, endorsed by NHS England:· https://www.england.nhs.uk/akiprogramme/aki-algorithm/The Management of acute kidney injury in adults in Primary Care by Barnsley Hospital NHS Trust: · https://best.barnsleyccg.nhs.uk/media/hruaaymn/best-december-2015-barnsley-aki-primary-careguidance-pathway.pdf?form=MG0AV3The Adult Acute Kidney Injury Care Pathway for Primary Care by King’s College Hospital NHS Trust:· https://www.kch.nhs.uk/wp-content/uploads/2023/01/mi-169.2-adult-acute-kidney-injury-care-pathway.pdfA calculator for the National Early Warning Score (NEWS):· https://www.mdcalc.com/calc/1873/national-early-warning-score-newsTranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the NICE recommendations on the management of acute kidney injury, focusing on what is relevant in Primary Care only. We will also cover the Primary Care flowchart on AKI by Barnsley Hospital NHS Trust and King’s College Hospital NHS Trust. You can find links to them in the episode description. If you have not already done so, I recommend that you check the previous episode on AKI covering the diagnosis, investigations and recommendations on the use of contrast media. Right, let’s jump into it. What management does NICE recommend? Well, managing acute kidney injury in primary care settings is generally limited, as it often requires specialised hospital monitoring and treatment. We are also likely to feel apprehensive keeping these patients in Primary Care, given the severity of some causes of AKI, such as sepsis, or some of its complications, such as acidosis and hyperkalaemia. Although NICE does not spell out which cases can potentially be managed in Primary Care, some other guidelines do provide us with some guidance, stating that primary care management can be justified, particularly for lower-risk cases. I have looked at the guidelines on the management of AKI by Barnsley Hospital and King’s College Hospital and we will go through them a little later. But for now, let’s stick to the NICE guideline. In terms of pharmacological management:...