Search
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
- Optimize volume status and perfusion pressure
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.