Who’s at risk of acute kidney injury? Developing a score to use in general practice amongst patients with hypertension

In this episode, we talk to Dr James Sheppard, who is an Associate Professor at the Nuffield Department of Primary Care Health Sciences at the University of Oxford. Title of paper: Predicting the risk of acute kidney injury: Derivation and validation of STRATIFY-AKIAvailable at: https://doi.org/10.3399/BJGP.2022.0389Acute kidney injury (AKI) is one of the more serious adverse events associated with antihypertensive treatment, reducing an individual’s health-related quality of life and increasing the risk of admission to hospital. Clinical guidelines recommend that when prescribing antihypertensives GPs should take into account the likelihood of both the benefits and harms from treatment, but few data exist in regard to the risk of AKI. A clinical prediction model was developed and externally validated for the risk of AKI up to 10 years in the future in patients eligible for antihypertensive medication, incorporating commonly recorded patient characteristics, comorbidities, and prescribed medications. The model showed good discrimination and good calibration for probabilities up to 20%, enabling GPs to accurately identify patients at higher risk of AKI. This could be useful to reassure the majority of patients starting or continuing treatment that their risk of AKI is very low.