23rd June 2023

General principles

Management of an acute kidney injury will depend on the underlying cause, however, principles that can be applied in all scenarios or until the cause is known include:

• Ensure obstruction has been excluded
• Review drug chart – hold nephrotoxic drugs and ensure renal dosing of necessary drugs such as antibiotics.
• Fluid status management – avoid hypotension, which could worsen a renal insult, and resuscitate a hypovolaemic patient with a likely pre-renal AKI (being careful to reassess regularly and avoid fluid overload).
• Fluid balance monitoring – consider a catheter, ensure fluid inputs/outputs are documented and weigh the patient daily.
• Regular blood tests to check urea and electrolytes
• Maintain good nutrition – consider referring to a dietitian