This report is a comprehensive summary of AKI alerts in 2018 submitted to the UKRR by laboratories serving NHS providers in England. Almost 90% of labs submitted data of sufficient quality to be included in the analyses. These data were linked to HES and ONS and the results are described by CCG, AKI stage and where the alert was generated - hospital or community setting.

The key findings were:

• 87% of laboratories in England submitted AKI data for 2018 - 1.5 million AKI alerts for 488,856 people, which represented over 564,738 AKI episodes.
• The unadjusted rate of AKI episodes in England was 12,300 per million population, with significant variation between CCGs - 5,300 to 20,700 per million population.
• 71% of people with an AKI episode had a hospital stay - 39% with community acquired and 32% with hospital acquired AKI. Median length of stay was 12 days in hospital and was more than double in hospital acquired than in community acquired AKI.
• 18% of people with an AKI episode died within 30 days of the first alert. This increased with peak AKI stage – 13% for stage 1, 29% for stage 2 and 33% for stage 3.
• Mortality within 30 days of hospital acquired AKI was 24%. Mortality at 30 days was higher in those from lower socio-economic background and in winter (January to March).