General treatment-acute kidney injury (AKI)

(CJASN 2008;3:962)

• Prerenal: isotonic IVF ≈ alb (NEJM 2004;350:22). No clear benefit of balanced crystalloids (eg, LR) over normal saline (NEJM 2018;378:829 & 2022;386:815).

• Avoid nephrotoxic insults (meds and contrast); renally dose medications

• Optimize hemodynamics (both MAP & CO) and maintain euvolemia (NEJM 2007;357:797)

• No benefit to dopamine (Annals 2005;142:510), diuretics (JAMA 2002;288:2547), or mannitol