Expert Witness Journal Issue 63 October 2025 - Flipbook - Page 14
‘Think Kidneys’ in all your
clinical negligence cases
by Adnan Sharif
5. They Are Easily Linked to Standards of Care
As highlighted above, national and international
guidelines (such as NICE or KDIGO respectively)
set clear expectations for monitoring and managing
at-risk patients. This makes it easier to establish
whether care fell below an acceptable standard.
Kidney problems are central in many medical
negligence cases because they are both common
and highly preventable. The kidneys are vulnerable
to harm from dehydration, infection, surgery,
and medications, yet their function can be easily
tracked with standard blood tests and urine
measurements. This combination makes kidneyrelated complications a clear marker of whether
proper care was delivered.
The Importance of Kidney-Related Complications
in Medical Negligence Cases
Kidney-related complications are increasingly
prominent in medical negligence litigation because
kidneys have an important role to play in wellbeing
and they can su昀昀er from both acute illness and/
or chronic health issues. The kidneys play a vital
role in 昀椀ltering toxins, regulating blood pressure,
and maintaining 昀氀uid balance. This makes them
highly vulnerable to harm from delayed diagnoses,
medication errors, and inadequate monitoring.
Because kidney function is measurable with
objective markers such as serum creatinine, eGFR,
and urine output, these cases are particularly well
suited to legal scrutiny. Below are the most common
kidney problems encountered in negligence claims.
Why Kidney Problems Are So Important to Pick
Up in Negligence Cases
1. They Are Common in Healthcare Settings
Acute kidney injury (AKI) occurs in up to one in 昀椀ve
hospitalised patients, and chronic kidney disease
(CKD) a昀昀ects millions of people in the United
Kingdom. Their frequency means they often arise
in negligence claims, particularly after hospital
admissions, surgeries, or critical illness – either
in isolation or in combination with other medical
illness or surgery.
2. They Are Often Preventable
Many kidney complications can be avoided with
basic steps: checking creatinine levels, monitoring
urine output, adjusting drug doses, and ensuring
proper hydration. There are many national
and international guidelines, including NICE
recommendations, for measures to prevent AKI.
Despite these recommendations, AKI rates are
high. When these preventative steps are missed, the
resulting harm may re昀氀ect a breach of duty.
1. Acute Kidney Injury (AKI)
• Description: A sudden decline in kidney
function, usually over hours to days.
• Causes in negligence cases:
ɿ Sepsis, poor hydration, inapprorpiate
medication, major surgery etc.
ɿ Failure to recognize reduced urine
output.
ɿ Delayed action on rising creatinine
levels.
ɿ Inappropriate or continued use of
nephrotoxic drugs (e.g., NSAIDs,
aminoglycosides, IV contrast) without
monitoring.
ɿ Poor 昀氀uid management (either
underhydration or 昀氀uid overload).
3. They Have Clear Diagnostic Markers
Unlike some conditions, kidney function is
measurable and objective. Rising creatinine
and/or falling eGFR values provide a timeline that
can be analysed to see if clinicians acted promptly
or negligently. These are routine blood tests and will
be available for patients in primary care or hospital
settings.
•
4. They Lead to Serious Consequences
Failure to detect kidney problems can cause
permanent renal failure, dialysis dependence and/
or death. Advanced kidney disease or kidney failure
has a major negative impact on quality of life and
survival. These poor outcomes carry signi昀椀cant
damages, making them high-stakes issues in
litigation.
EXPERT WITNESS JOURNAL
12
Why it matters legally:
ɿ AKI is often preventable with proper
monitoring and early intervention.
ɿ Courts can evaluate whether standard
guidelines (e.g., KDIGO, NICE) were
followed.
ɿ Missed AKI can progress to chronic
kidney disease or dialysis dependence,
leading to high compensation claims.
OCTOBER/NOVEMBER 2025
