Acute Kidney Injury : Interprofessional Care

  • Interprofessional Care
    • Primary goals
      • Eliminate cause
      • Manage signs and symptoms
      • Prevent complications
    • Ensure adequate intravascular volume and cardiac output
      • Force fluids
      • Loop diuretics (e.g., furosemide [Lasix])
      • Osmotic diuretics (e.g., mannitol)
    • Closely monitor fluid intake during oliguric phase
    • Hyperkalemia
      • Insulin and sodium bicarbonate
      • Calcium carbonate
      • Sodium polystyrene sulfonate (Kayexalate)
    • Indications for renal replacement therapy (RRT)
      • Volume overload
      • Elevated serum potassium level
      • Metabolic acidosis
      • BUN level > 120 mg/dL (43┬ámmol/L)
      • Significant change in mental status
      • Pericarditis, pericardial effusion, or cardiac tamponade
    • Renal replacement therapy (RRT)
      • Peritoneal dialysis (PD)
        • Not frequently used
      • Intermittent hemodialysis (HD)
      • Continuous renal replacement therapy (CRRT)
        • Cannulation of artery and vein
    • Nutritional therapy
      • Maintain adequate caloric intake
        • Primarily carbohydrates and fat
        • Limited protein
      • Restrict sodium
      • Increase dietary fat
      • Enteral nutrition