A Multidisciplinary and International Assessment of Acute Kidney Injury Awareness

Technical note: 

On behalf of BioMérieux, Ipsos MORI UK Ltd conducted an online survey with 1006 healthcare professionals across 6 countries (UK n=101, France n=100, Germany n=101, Spain n=100, Italy n=102 and USA n=502) between 27th August and 25th September 2020. A quota sample of Healthcare professionals were interviewed with roughly equal number of participants in each of the following 5 areas: 1) intensivists / intensive care unit (ICU) physicians, 2) emergency department physicians, 3) cardiologists, 4) hospitalists / internist (USA), internal medicine physicians (ex-USA) and 5) Nephrologists who chose to take part in the survey. All physicians spend at least 70% of their professional time in clinical practice with patients, they spend the majority of their clinical time in a teaching / university hospital or non-teaching hospital and their hospital which they spend the majority of their time has either an emergency department, intensive care unit / critical care unit / high dependency unit, renal unit dialysis unit. All healthcare professionals must have been qualified in their role for a least 2 years and they must be either the primary decision maker, one of the decision makers or consulted for their opinion on a final decision when it comes to prescribing of diagnostic tests and medications for patients.

The analysis provides a total weighted average to ensure all Europe (the sum of five European countries) had an equal weighting with the US in results participating countries had equal weighting in the data.

Key findings from the study: 

• Approximately half of surveyed HCPs (52%) use the term ‘Acute Kidney Injury’. Terminology varies widely across markets with Acute kidney failure more common in France and Germany and Acute renal failure in Spain. 
• 90% of HCPs surveyed are very familiar with AKI – in line with other acute conditions such as sepsis (89%), pulmonary embolism (88%) and myocardial infarction (88%). 
• HCPs surveyed agree that AKI is common in hospital in the intensive care unit (96%) and outside the intensive care unit (87%). 
• 98% of surveyed HCPs agree that AKI increases morbidity and mortality, and 96% agree that is not mitigated, it could lead to chronic kidney disease. 
• 87% of surveyed HCPs would like to learn more about the prevention, detection, and treatment of acute kidney injury 
• HCPs surveyed know the stage of AKI for 93% of their patients – the largest single group in stage 1 (42% of patients in stage 1). 
• 76% HCPs surveyed state that based on their experience that they would always think about the potential risk of AKI among a patient with distributive (septic) hypovolemic or cardiogenic shock and 69% for those with CKD 
• 96% of HCPs surveyed agree or strongly agree that early detection of AKI can lead to significantly better patient outcomes 
• HCPs surveyed believe that around 1 in 3 (34%) AKI cases could have been prevented
• 41% of HCPs surveyed use the KDIGO guidelines for either detection or treatment / management of AKI. The remainder will use specialist advice from a nephrologist or hospital protocols
• HCPs surveyed take a range of steps to monitor AKI patients – HCPs have used monitor serum creatine in 88% of their patients under their care in hospital.  However, steps stated in guidelines are not followed in every patient
• Only 68% of HCPs surveyed see AKI as a condition that commonly leads to chronic illness – behind stroke (87%) and myocardial infarction (85%), and similar to acute exacerbation of COPD (69%). 
• HCPs state that 1 in 5 (18%) patients seen in a typical week, that they personally manage in hospital die from AKI – less than sepsis (21%), but more than myocardial infarction (14%) & other conditions