The AKI Specialist Interest Group (SIG)

An overview from the Chairs Jonathan Murray and Clare Morlidge

The AKI SIG was initially formed in 2019; however was put on hold due to the COVID-19 pandemic and set up officially in 2021 and co-chaired by Jonathan and Clare. There are members from across the multi-professional team within each of the four work streams working across primary and secondary care, and including other interested parties.

The workstreams are co-chaired by a medic and a non-medic as per the group’s terms of reference:

  • Data and Measurement – led by Will McKane and Retha Steenkamp
  • Education – led by Karen Nagalingam and Lynne Sykes
  • Governance – led by Marlies Ostermann and Nicola Geraghty
  • Quality Improvement and Implementation - led by Gowrie Balasubramaniam and Becky Bonfield

This organogram illustrates the multi-professional composition and system-wide vision of the AKI SIG. 

AKI organisational overview

The workstream Co-Chairs communicate regularly with each other and the overall SIG Chairs to ensure cross-workstream working is coordinated, consistent and efficient; synergistic working is encouraged to support outputs and avoid unnecessary duplication or inconsistency. The SIG has established links with relevant UKKA Committees/groups, such as the UK Renal Registry, Patient Safety, Patient Information, KQIP, Association of Nephrology Nurses UK (ANN UK), Renal Pharmacy Group (RPG), Renal Nutrition Group (RNG) and the Kidney Research UK Clinical Study Group.

The AKI SIG has built upon the achievements of the Think Kidneys programme, which ran from around 2016 to 2019, further helping to establish AKI as a national patient safety priority.

AKI becoming a national patient safety priority

Think Kidneys oversaw the introduction of AKI e-alerts utilising an NHSE AKI algorithm and leveraged an NHSE patient safety alert (2014) to mandate laboratories nationwide to comply. The Think Kidneys campaign and AKI SIG have re-invigorated enthusiasm for AKI, systemwide, involving cross-specialty, cross-sector, multi-professionals and patients. AKI SIG members continue to maintain and update Think Kidneys’ resources. 

During the pandemic, members of the AKI SIG contributed to NICE rapid guidance to help optimise care for people sustaining AKI associated with COVID-19. In addition, AKI SIG members collaborated with Intensive Care Society multi-professionals to rapidly co-develop NICE-accredited guidelines to support best practice and service resilience to enable renal support for critically unwell patients with AKI during the pandemic, including advice on medication dosing for patients receiving renal support in critical care settings. 

The AKI SIG outputs include:

  • A national survey to evaluate the composition and variation of AKI services provided by acute NHS hospitals in England (2022).
  • Co-produced national recommendations to standardise laboratory AKI detection and reporting, in collaboration with other stakeholders (ACB, GIRFT Pathology), in May 2023. An audit is being repeated in 2025 to evaluate the impact of these recommendations.
  • The SIG has supported the development and utilisation of UK Renal Registry (UKRR) AKI data portals and dashboard: it supported the UKRR with the development of the AKI Master Patient Index (unique worldwide). We worked with the RSTP to link MPI data with patient outcome and service use data (HES and SUS), and this work is still being completed.
  • Members of the SIG supported the NHSE RSTP AKI programme, helping to develop the RSTP AKI toolkit and continue to champion AKI as a priority area for Regional Renal Clinical Networks, also being part of the AKI Community of Practice
  • The SIG has further formally contributed to national guideline development, including the NICE evidence surveillance report: to help secure review/update of contrast nephropathy section of NICE AKI guidelines (NG 148) and an NHS England Nutrition and Hydration policy (currently in progress) to raise awareness around fluid balance.
  • Education: a first AKI education training package has been developed in 2025, for the Educational Hub of the UKKA website. Further packages will be developed to support learning of the whole MPT within AKI.
  • The AKI SIG held a National AKI face-to-face AKI Summit, in Birmingham (September 2023). This brought together 120 multi-professionals, cross-specialty and care sectors, thereby ensuring delegates were representative of the AKI workforce. The summit report, which includes 24 recommendations, has been endorsed, co-badged and circulated by partner national organisations (RCP, SAM, BHS, RMG, ANN UK, BGS, ICS) to promote consistent system-wide AKI care. Some AKI SIG members are currently helping to develop articles to further support awareness and delivery of the recommendations developed during and after the national AKI summit.

The SIG is open to all UKKA members of the whole MPT to join and to take part in the workstreams.