KDIGO Clinical Practice Guideline for Acute Kidney Injury
Overview

Chapter 3.2: General supportive management of patients with AKI, including management of complications

Supportive management to prevent AKI was discussed in the previous chapter and, for many patients, many of the supportive therapies will continue even if AKI develops. Furthermore, an important goal of early management of AKI is to prevent further injury and to facilitate recovery of renal function. These goals can often best be achieved by strict attention to supportive therapy. However, as renal function deteriorates, complications arise that require different management. Some of these issues have been discussed in Chapter 2.3 and several books have been devoted, in large part, to management of the many complications that arise from AKI^130–133; the reader is referred to these sources. Particular attention should be given to the assessment of the circulating volume and fluid administration, the prevention and/or treatment of hyperkalemia and metabolic acidosis, the knowledge of the changes in pharmacokinetics of many drugs with discontinuation of all potentially nephrotoxic drugs, and dose adaptation of drugs excreted by the kidneys to the patient’s renal function. Finally, many of the other chapters in this section of the guideline deal with supportive measures (e.g., diuretics for fluid management).