BACKGROUND National Health Service England issued a Patient Safety Alert in 2014 mandating all acute Trusts in England to implement Acute Kidney Injury (AKI) warning stage results and to do so using a standardised algorithm. In 2021, the Renal and Pathology Getting It Right First Time (GIRFT) teams found significant variation in AKI reporting across the UK. A survey was designed to capture information on the entire AKI detection and alerting process to investigate the potential sources of this unwarranted variation. METHODS In August 2021, an online survey consisting of 54 questions was made available to all UK laboratories. The questions covered creatinine assays, laboratory information management systems (LIMS), the AKI algorithm and AKI reporting. RESULTS We received 101 responses from laboratories. Data were reviewed for England only - 91 laboratories. Findings included that 72% used enzymatic creatinine. In addition, 7 manufacturer-analytical platforms, 15 different LIMS and a wide range of creatinine reference ranges were in use. In 68% of laboratories, the AKI algorithm was installed by the LIMS provider. Marked variation was found in the minimum age of AKI reporting with only 18% starting at the recommended 1 month/28-days. Some 89% phoned all new AKI2s and AKI3s, as per AKI guidance while 76% provided comments/hyperlinks in reports. CONCLUSIONS The national survey has identified laboratory practices that potentially contribute to unwarranted variation in the reporting of AKI in the England. This has formed the basis for improvement work to remedy the situation, including national recommendations, included within this article.

中文翻译：

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标准化急性肾损伤检测和警报的国家建议。

背景 英国国家卫生服务中心于 2014 年发布了患者安全警报，要求英格兰所有急性肾损伤 (AKI) 预警阶段结果并使用标准化算法来实施。2021 年，肾脏和病理学首次正确 (GIRFT) 团队发现英国各地 AKI 报告存在显着差异。一项调查旨在捕获整个 AKI 检测和警报过程的信息，以调查这种不必要的变异的潜在来源。方法 2021 年 8 月，向所有英国实验室提供了一项包含 54 个问题的在线调查。问题涵盖肌酐测定、实验室信息管理系统 (LIMS)、AKI 算法和 AKI 报告。结果 我们收到了来自实验室的 101 份回复。仅审查了英格兰 91 个实验室的数据。研究结果包括 72% 使用酶促肌酐。此外，还使用了 7 个制造商分析平台、15 个不同的 LIMS 和广泛的肌酐参考范围。在 68% 的实验室中，AKI 算法由 LIMS 提供商安装。AKI 报告的最低年龄存在显着差异，只有 18% 的人从建议的 1 个月/28 天开始。根据 AKI 指南，约 89% 的人给所有新的 AKI2 和 AKI3 打电话，而 76% 的人在报告中提供了评论/超链接。结论 全国调查发现实验室实践可能导致英格兰 AKI 报告出现不必要的变化。这构成了纠正这种情况的改进工作的基础，包括本文中包含的国家建议。