This handout is for acute kidney injury (kdigo). Your care team identified this based on: creatinine rise ≥0.3 in 48h or ≥1.5x baseline in 7d (kdigo 2012).
Other reasons your team may use this plan: oliguria <0.5 ml/kg/h ≥6h (kdigo 2012); anuria / decreased urine output (kdigo 2012); hyperkalemia or metabolic acidosis on routine bmp (kdigo 2012 aeiou).
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| lactated_ringers | 10-20 mL/kg bolus | IV | titrate to MAP >65 + UOP >0.5 mL/kg/h | KDIGO 2026 + SMART/PLUS — balanced crystalloid preferred over saline to avoid hyperchloremic acidosis |
| sodium_chloride_0.9% | 10-20 mL/kg bolus | IV | titrate | Acceptable when balanced crystalloid unavailable |
Plan: AKI phenotype-driven management (KDIGO 2012/2026)
Call 911 or go to the nearest emergency room right away if you have:
Recheck Cr 1 week post-discharge; nephrology outpatient; 3-month reassessment for CKD progression; med-rec post-AKI
Guideline: KDIGO 2026 AKI/AKD Draft (public review through April 2026; https://kdigo.org/guidelines/acute-kidney-injury/) + KDIGO 2012 AKI Guideline (binding) + SSC 2026 (initial resuscitation) + AASLD 2023 ACLF (HRS-AKI) + CONFIRM NEJM 2021 (terlipressin) + DOSE NEJM 2011 (loop diuretic dosing) + SMART/PLUS (balanced crystalloid) + STARRT-AKI / AKIKI (early vs delayed RRT)