Understanding how certain medicines increase the risk of children developing acute kidney injury in hospital
Acute kidney injury (AKI) is when your kidney’s suddenly stop working properly. AKI happens to around 1 in 40 children in hospital. For some children this can have a lasting impact on their kidney health. Certain medicines, or combinations of medicines, can be harmful to the kidneys and sometimes cause AKI.
Kidney research UK and the Alder Hey Children's Kidney Fund have generously awarded £38,000 to Dr Louise Bracken and her team to develop a tool to record which medicines are prescribed to children in hospital that could be harmful to the kidneys, and which children develop AKI. In the future, this type of tool could be used to predict which medicines increase a child’s risk of AKI and identify children who may be at risk before any harm occurs.
What is acute kidney injury (AKI)?
Acute kidney injury (AKI) is when your kidneys suddenly stop working properly. Although AKI is usually temporary, it is a serious condition which can have longer lasting effects on your health, including your kidney function. One of the most common causes of AKI is certain medicines, used to treat other illnesses, which can sometimes be harmful to the kidneys.
Some medicines can increase the risk of children developing AKI in hospital
AKI happens to around 1 in 40 children in hospital. Although most of these children recover from AKI, it can have a serious impact on their health. Children who develop AKI may need to stay longer in hospital, and they are also at a higher risk of developing chronic kidney disease (CKD) in the future.
There are some medicines that children may be given in hospital that can harm the kidneys but are needed to treat illnesses. The risk of AKI can be higher if several of these medications are given at once, or if they are taken for a long time.
“We know sometimes children in hospital are given medicines that are potentially harmful to the kidneys. Although these medicines are often unavoidable as they’re needed to treat illnesses, we need to better understand which medicines, and combinations of medicines, are putting children at risk of AKI. This would mean we can choose the most appropriate treatments for children to treat their illness whilst monitoring and protecting their kidney health as much as possible.” Dr Louise Bracken
Finding new ways to identify AKI risk when prescribing medicines to children in hospital
Louise will work alongside Steve McWilliam, who is leading an ongoing project looking at health data from children at the Alder Hey Children’s hospital, to understand what factors, and combinations of factors, can lead to AKI developing.
Louise, Steve and their team will develop a real-time tool for collecting data at the Alder Hey Children’s hospital. They will record medicines that are prescribed to children that can be harmful to the kidneys. They will also collect data on kidney function and whether any of these children develop AKI. By comparing this data, they will identify how many children develop AKI linked to certain medicines or combinations of medicines. Louise and her team will also look at socioeconomic data, to see if this impacts the number of children prescribed these medicines and develop AKI. Following development of the tool, the team will run focus groups with healthcare professionals. The feedback will be used to look at how this tool could be best used to identify children in hospital at risk of AKI so that interventions can be made to protect their kidneys.
Meet Dr Louise Bracken
Dr Louise Bracken is a senior research pharmacist at Alder Hey Children's Hospital in Liverpool. Louise is also the Co-Director of the Paediatric Medicines Research Unit which brings together expertise to make medicines better and safer for children. This pharmacist start-up grant of £38,000, co-funded with the Alder Hey Children's Kidney Fund, will mean Louise and her team can develop a tool for recording medicines prescribed to children in hospital that can be harmful to the kidneys and investigate whether these children develop AKI.
“Stepping into research as a pharmacist, has given me the opportunity to find the solutions to problems I’ve seen in practice. It can be daunting taking the first step into research, pharmacists have a very logical approach, which is well suited to research, and I would say research should go hand in hand with clinical practice as research allows us to answer those key questions or change practice. I am grateful for this grant funded by Kidney Research UK and the Alder Hey Children's Kidney Fund and I hope this research can give us a better understanding of AKI risk in children and inform interventions to avoid AKI in the future.” Dr Louise Bracken
How can we protect the kidney health of children at risk of AKI from their medicines in hospital?
This new tool could be used by doctors, pharmacists and nurses in the future to identify children at risk of AKI. This would allow interventions, such as altering a prescription to avoid a medication or giving a lower dose, to protect the kidneys and reduce the risk of these children developing AKI.
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