NEPHwork is an SpR driven national SpR audit and research network supported by the UK Kidney Association.

Its aim is to develop, coordinate and deliver simple audit and research projects on a national scale by coordinating the activity of a large number of renal trainees. Kidney Research UK also provides financial support.

Current Projects

The NEPHwork group are looking for SpR in all the sites in the UK that are performing kidney biopsies to take part in the current project

The audit aims to compare both practice patterns and also pseudonomised patient level data on kidney biopsy practice in the UK.

The project is intended to complement the well established kidney biopsy audit run by the Scottish Renal Association ( to compare practice in England, Wales and NI also. SpR in Scottish centres would still be very welcome to discuss with their consultant supervisors how to take part in either or both initiatives.

If you are interested in helping with this audit please contact .  Initially we just need the details of the lead SpR, any other trainees (specialist or non-specialist) wishing to take part, and the details of a consultant supervisor

The protocol is here and practical advice on registering the audit locally here.

The second major project is IGNITE (InvestigatinG reNal bIopsy pracTice and outcomEs)

IGNITE is a UK-wide project that will provide a contemporary snapshot of native kidney biopsy practices, pathways and processes including set-up, procedural details, training opportunities and complications. Through this, IGNITE aims to characterise current inter-centre variation and support the production of guidance and associated resources to support renal biopsy training and practice.

IGNITE will consist of two phases:

  • Phase One – a questionnaire detailing current biopsy practices in your unit, including procedural ‘cut-offs’, antiplatelet protocols and DDAVP use.
  • Phase Two – retrospective collection of patient-level data covering a six-month period including consent, procedural details and complications.

What will involvement in IGNITE look like?

IGNITE is open to any centre where patients undergo renal biopsy (regardless of whether it is nephrology that performs the procedure). Having registered the study with your local audit department and completed the Phase One questionnaire for your site, you would have three months in which to complete and submit the retrospective data required for Phase Two.

The data collection period for the study will be May-August 2024 (completing prior to changeover). Data collection will be retrospective, for all patients who have undergone a native renal biopsy in your centre between August 2023-February 2024.

Participation is open to nephrology registrars as well as more junior trainees (IMTs/FYs/ Medical Students – a great way to get colleagues enthused about nephrology and boosting their CVs), non-training grade doctors and AHPs. Sites can have multiple collaborators and we encourage the formation of mini-teams led by nephrology registrars and incorporating clinicians of all grades at each participating site.

What can I expect in return for my contribution?

In line with other trainee collaborative projects, all collaborators (including the consultant supervisor) will be eligible for collaborator authorship on IGNITE outputs (including national/international presentations and publications) providing they meet the minimum requirement for data input at their site (completion of one Phase One questionnaire per site and submission of ten patients’ worth of biopsy data per collaborator in Phase Two). In addition, participation will demonstrate the training requirement to engage with audit.

If you would like to be kept updated with study developments - including being sent the study registration documents when available - please complete the form here. 

Previous projects

National AKI Audit 

The audit went live from the 1st December 2020 to the 31st January 2021 - see details here.

64 SpRs from acute trusts across England and Wales signed up to participate - see list of participants.

Benefits to SpRs

All contributors to NEPHwork projects will be listed on relevant web pages and authorship of all publications and presentations will be published on behalf of NEPHwork, so all contributors are equally represented and all can cite outputs as publications to which they have contributed. This is a great opportunity for trainees and trusts to be involved in national audit and we anticipate the results having a significant impact on the way services are developed and delivered, with the opportunity to link to future research and quality improvement.

For any questions about NEPHwork or support with the National AKI Audit, please contact


NICE accredited clinical practice guidelines 

Available here

25th Annual Report

Analyses about the care provided to patients at UK renal centres.

Read the report

2022 UKRR AKI Report

A report on the nationwide collection of AKI warning test scores. 

Read the report