Acute kidney injury (AKI) occurs in almost 50% of hospitalized patients and is an independent risk factor for mortality.
Updated guidelines have recently been published on the management of patients with AKI.
Pearls for the management of patients with, or at risk of, AKI include:
Optimize volume status and perfusion pressure
Crystalloids preferred over colloids
Consider vasopressors to maintain MAP > 65 mm Hg
Avoid nephrotoxic drugs
Control co-factors
Monitor intra-abdominal pressure
Avoid hyperglycemia - target glucose < 150 mg/dL
References
Brienza N, et al. Protocoled resuscitation and the prevention of acute kidney injury. Curr Opin Crit Care 2012; 18:613-622.
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int 2012; 2(S):1-138.
