Acute Kidney Injury (AKI)

👤 Who gets it

Common in acute illness — hypovolaemia/sepsis, nephrotoxins, or obstruction; higher risk with pre-existing CKD, diabetes, heart failure and older age.

🔎 Work-up / diagnosis

1. 1Stage with KDIGO (creatinine rise or a drop in urine output).
2. 2Classify the cause: pre-renal (hypoperfusion), intrinsic renal, or post-renal (obstruction).
3. 3Assess volume status, review drugs (nephrotoxins), do urinalysis, and get a renal ultrasound to exclude obstruction; check electrolytes and acid-base.

🧭 Management — overview

• ✓Treat the cause: restore circulating volume for pre-renal AKI (fluids), relieve obstruction (catheter/nephrostomy) for post-renal, and treat intrinsic causes (e.g. sepsis, glomerulonephritis).
• ✓Stop nephrotoxins (NSAIDs, ACE inhibitors/ARBs during AKI, contrast) and adjust renally-cleared drug doses.
• ✓Manage complications — hyperkalaemia, acidosis and fluid overload.
• ✓Dialyse for refractory hyperkalaemia, severe acidosis, fluid overload, or uraemic complications.
• ✓Monitor fluid balance and daily bloods; most pre-renal AKI recovers with prompt treatment.

📚 References

• OtherKDIGO Clinical Practice Guideline for Acute Kidney Injury ↗
• ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗
• WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

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