All patients admitted to hospital as an emergency should have their electrolytes checked on admission and appropriately thereafter, recommends a UK confidential inquiry that found serious deficits in the care for many patients who died in hospital with acute kidney injury (AKI).

Only half of these patients had received good clinical care, according to an assessment by independent experts of their case notes and information on their management. Care was judged to have been good in even fewer, only one in three, patients who developed acute kidney injury after hospital admission, compared with patients admitted with the problem.

Acute kidney injury could have been avoided in one fifth of the patients who developed it after admission to hospital if they had received better monitoring of electrolytes, recognition of risk factors, and prompt management, the inquiry says.

“Failure of the heart or the lungs to maintain their life-sustaining roles is immediately evident but when the kidneys fail in their function it may go unnoticed,” explained Tom Treasure, chairman of the National …