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NICE guideline on acute kidney injury

Metformin is first-line drug therapy in type 2 diabetes. A recently published NICE guideline on acute kidney injury reminds us that we should consider this condition in people using metformin, particularly if they are over 65, have an intercurrent illness or take other potentially toxic medications.

by Colin Kenny, GP, Dromore, County Down

NICE has published a guideline document on acute kidney injury (AKI). The document explains the transition of the term acute renal failure to AKI. It also outlines an at-risk population – people with diabetes who are over 65, who have intercurrent illness, or who are using metformin or angiotensin-converting enzyme inhibitors all feature prominently in the guideline.

This advice is clear. Primary care teams should recognise the potential risk, counsel patients carefully, and give them written guidance on what they, and their carers, should do during intercurrent illness, especially if there is a poor urine output. Be clear on drugs to avoid or stop during illness. An ill individual will need urgent referral for investigations and assessment.

To access the full guidance click here (link to external website)

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