Safe People
Lead applicant organisation name	University Hospital Birmingham

Safe Projects
Project title	Post-operative acute kidney injury in major non-cardiac surgery – a retrospective study to identify epidemiology and risk factors
Lay summary	"The kidneys are two organs that work as a pair of special filters allowing waste to be filtered from the blood into the urine for removal from the body. Healthcare staff do blood tests to measure the levels of creatinine, one of these waste products, to assess how well the kidneys are working. When kidneys are damaged and filter less effectively, more creatinine stays in the blood. When tests show creatinine levels have gone up by 150% or more over seven days or less, an acute kidney injury (AKI) is said to have happened. AKI is important as injury can signpost progression to outright kidney failure. AKI often happens after severe stresses found in major surgery. This type is called post-operative acute kidney injury (po-AKI). Although much is known about po-AKI, much remains to be learned. Patients who develop po-AKI are more likely to have outright kidney failure, post-operative complications, longer hospital stays, and a lower chance of leaving hospital alive. They are also more likely to experience medical problems after getting home, including heart diseases and worsening kidney function. However, there is a lack of clarity over simple questions, such as how common po-AKI is in elective major surgery in the UK and what can be done to reduce its occurrence and impact."
Public benefit statement	"Locally, this study will raise awareness of po-AKI and its importance. Researchers will collaborate with colleagues and UHB Informatics to explore using inclusion/exclusion criteria and AKI classification systems to develop dashboards for surgical specialties and anaesthesia. These dashboards could track po-AKI rates on a rolling three-month basis, enabling real-time analysis and prevention strategies. On a wider scale, this project will contribute NHS-specific data on po-AKI epidemiology, addressing gaps left by US and SE Asian studies. It will provide new risk factor data linked to peri-operative myocardial injury. Conducting interventional trials in po-AKI requires large patient numbers, as most do not develop po-AKI. A cost-effective approach is enrichment—selecting high-risk patients. Many trials use age as a cut-off, but this study identifies biological traits like heart rate and blood pressure as better predictors. This allows trials to remain small and targeted without disadvantaging younger patients."
Latest approval date	09/02/2024

Safe Data
Dataset(s) name	PATHWAY Research Data Hub: PWY015 dataset

Safe Setting
Access type	Data released via Letter of Authorisation. All researchers have received training in the care, use and protection of personal data, enabling them to comply with their responsibilities under the Data Protection Act.

Safe Outputs
Link	Not yet Published