UMEM Educational Pearls

Category: Critical Care

Title: Management of AKI

Posted: 11/27/2012 by Mike Winters, MD (Updated: 9/27/2022)
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Managing Critically Ill Patients with AKI

  • 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.