NEPHwork is a registrar-driven national audit and research collaborative supported by the UK Kidney Association and the UK Renal Registry. It aims to develop, coordinate, and deliver audit and research projects on a national scale by harnessing the collective efforts of resident doctors in nephrology from across the UK.
Formed in 2019 by the UK Specialty Renal Trainees, NEPHwork has delivered two successful national projects: an AKI audit, which resulted in two publications and a UK Renal Registry report, and IGNITE, an audit of kidney biopsy practices and complications. Further details of both projects can be found below.
Chair
Vice Chair
Medical Director, UKRR
Clinical Vice President, UKKA
NEPHwork Founder
We are very excited to be launching our new project, BK-UK – a national audit of clinical practice and patient outcomes in BK Polyomavirus infection among adult and paediatric kidney transplant recipients.
We are hoping to get as many centres across the UK involved as possible, so please come and join the project!
View our flyer for further information.
BK-UK is a UK-wide project that seeks to collect clinical data from kidney transplant patients who developed BK Polyomavirus infection over a five-year period between 2019 and 2024.
BK-UK is the third major project adopted by NEPHwork and aims to generate the most comprehensive dataset of BK Polyomavirus incidence, management and outcomes in the world. The insights from this will change how we care for kidney transplant patients in future.
BK-UK is open to all renal centres – including adult, paediatric and non-transplanting centres – in the UK. Having registered the study with your local audit department, you will have three months to complete the retrospective patient-level data entry form.
Participation is open to nephrology registrars as well as more junior colleagues and interested allied health professionals. Sites can have multiple collaborators, and we encourage the formation of mini teams led by nephrology registrars and incorporating all registered participants at each site. This may be particularly important in large transplant centres, where the number of patients may be high.
All collaborators (including local consultant supervisors) will be eligible for collaborator authorship on BK-UK outputs (including national/international presentations and publications) providing they meet the minimum requirement for data input at their site.
The minimum requirement for data input is 10 patients’ worth of complete data per collaborator (or complete data collection for the five-year period if the site has less than 10 cases over the period).
In addition to being a key part of a national audit that will improve our understanding of how to care for kidney transplant patients, participation will demonstrate the training requirement to engage with audit. For those applying to renal medicine specialty training, BK-UK is a great opportunity to demonstrate commitment to the specialty.
If you are interested in being involved in BK-UK, please register your interest here.
We encourage you to speak to your colleagues and will aim to put individuals who register at the same site in touch so that data collection can be divided.
We look forward to working with you!
IGNITE was the second of NEPHwork’s national projects and consisted of a two-phase multi-centre observational study.
Phase One captured unit-level data on native kidney biopsy procedure through dissemination of questionnaires completed by local teams. Data captured included biopsy location, operator status, equipment and pre-procedural patient safety parameters.
Phase Two consisted of a retrospective case note audit on all consecutive adult patients undergoing native kidney biopsy between August 2023-February 2024 in participating centres. This included the variables examined in Phase One, and additionally data were collected regarding peri-procedural medication, consent and complications.
32 renal units participated in Phase One, while 1,713 native kidney biopsies were entered into Phase Two. Of these biopsies, approximately 60% were performed as day-case procedures, and nearly 50% were performed by nephrology registrars. Complications were recorded in 100 biopsy cases (5.8%), with major complications occurring in 1.9% of cases, including blood transfusion, arteriography, embolisation, bladder washout for clot retention, surgery or death.
A full report of the data will follow in due course.
This was the first of NEPHwork’s national projects and went live in December 2020.
64 Specialty Renal Trainees from acute trusts across England and Wales participated, auditing the care of patients with Stage 2 and 3 AKI against the 2019 Renal Association Clinical Practice Guideline.
989 AKI episodes were included in the analyses, which found an in-hospital 30-day mortality rate of approximately 30% and AKI interventions were completed in >80% of episodes. The audit identified significant inter-hospital variation in attainment of AKI care standards, particularly around recording of urinalysis, which was documented in 41.9% of cases, and timely imaging, which was completed in 37.2% of cases.
The findings were published in Clinical Medicine and are available to read here.