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    Acute Kidney Injury Poster

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    mmbire@gmail.com
    Acute kidney injury is initially managed by checking renal function on all emergency admissions and every 24 hours if AKI is present. Urinalysis and staging of AKI using creatinine and urine output criteria helps determine the cause and severity. Renal referral is recommended for stage 1 AKI if the cause is uncertain, and for all stage 2 and 3 AKI cases unless the diagnosis and plan are clear with evidence of rapid improvement. Management of all stages of AKI follows the "STOP AKI" approach - seeking and treating sepsis, avoiding nephrotoxins, considering obstruction, and evaluating for parenchymal kidney disease.

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    Acute Kidney Injury Poster

    Uploaded by

    mmbire@gmail.com
    80 views1 page
    Acute kidney injury is initially managed by checking renal function on all emergency admissions and every 24 hours if AKI is present. Urinalysis and staging of AKI using creatinine and urine output criteria helps determine the cause and severity. Renal referral is recommended for stage 1 AKI if the cause is uncertain, and for all stage 2 and 3 AKI cases unless the diagnosis and plan are clear with evidence of rapid improvement. Management of all stages of AKI follows the "STOP AKI" approach - seeking and treating sepsis, avoiding nephrotoxins, considering obstruction, and evaluating for parenchymal kidney disease.

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    Acute Kidney Injury poster

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    Acute kidney injury is initially managed by checking renal function on all emergency admissions and every 24 hours if AKI is present. Urinalysis and staging of AKI using creatinine and urine output criteria helps determine the cause and severity. Renal referral is recommended for stage 1 AKI if the cause is uncertain, and for all stage 2 and 3 AKI cases unless the diagnosis and plan are clear with evidence of rapid improvement. Management of all stages of AKI follows the "STOP AKI" approach - seeking and treating sepsis, avoiding nephrotoxins, considering obstruction, and evaluating for parenchymal kidney disease.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    80 views1 page

    Acute Kidney Injury Poster

    Uploaded by

    mmbire@gmail.com
    Acute kidney injury is initially managed by checking renal function on all emergency admissions and every 24 hours if AKI is present. Urinalysis and staging of AKI using creatinine and urine output criteria helps determine the cause and severity. Renal referral is recommended for stage 1 AKI if the cause is uncertain, and for all stage 2 and 3 AKI cases unless the diagnosis and plan are clear with evidence of rapid improvement. Management of all stages of AKI follows the "STOP AKI" approach - seeking and treating sepsis, avoiding nephrotoxins, considering obstruction, and evaluating for parenchymal kidney disease.

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    Acute Kidney Injury – Initial Management And Referral

    Renal Function should be checked on all Emergency Admissions (then every 24 hours if AKI)

    Urinalysis for all Staging AKI (Creatinine and Urine Output criteria) Accurate fluid
    balance/observations

    Blood Proteinuria Leucocytes


    If high early warning score
    request critical care
    Vasculitic ACR MSU
    screen:
    outreach review.
    If hypotensive despite
    ANCA
    ANA adequate fluid resuscitation
    C3, C4, or systolic BP < 90mmHg
    Cryoglob after > 2 L fluid then senior
    Myeloma +/- outreach review.
    screen: Caution required for heart
    Igs
    SFL
    failure patients: use clinical
    judgement for degree of
    volume replacement.
    Renal referral for Acute Kidney Injury
    AKI Stage 1 Refer only if cause uncertain, suspected vasculitic or complications of AKI (high potassium etc)
    AKI Stage 2 All except for those where the diagnosis & plan are clear with evidence of rapid improvement
    AKI Stage 3 All patients should be referred & discussed with renal team unless palliative

    Management for all stages of AKI = “STOP” AKI


    S SEPSIS / HYPOTENSION / PRERENAL / ATN. Antibiotics within 1 hour (renal dosing). Avoid empirical gentamycin in AKI. Relevant cultures (urine/blood) before antibiotics. Adequate fluid resuscitation.
    T TOXINS – All patients should have a nephrotoxic medication review (e.g. NSAID/ACEi/ARB) avoid post-operative NSAID
    O OBSTRUCTION - AKI is usually fully reversed if obstruction relieved promptly. USS scan within 24 hours
    P PARENCHYMAL / INTRINSIC RENAL DISEASE, think rapidly progressive gn such as vasculitis in someone with rash & active urine sediment. Rhabdomyolysis if clinically suspected (CK).
    If anaemic/low platelet count consider HUS/TTP. Tubulointerstitial nephritis if new drug commenced recently & no obvious alternative cause.

    For detailed guidelines refer to the Black Country Network AKI guidelines which is available on the Pathology Website
    (http://www.royalwolverhampton.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=5252 ) and the Renal intranet pages.

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