Acute kidney injury

Questions discussed in this category

Would you consider restarting a SGLT2i at a reduced dose in a patient who you previously discontinued the medication because of an associated significant decline in eGFR?

1 Answer available

Do you recommend any CRRT prescription changes for optimal clearance for patients with AKI who are on a reduced blood flow rate due to concurrent regional citrate anticoagulation?

2 Answers available

What is your preferred intravenous fluid type for matching volume loss in a patient with persistent surgical drain output and pre-renal acute kidney injury?

1 Answer available

Would you recommend administering IV amino acids prior to cardiac surgery with cardiopulmonary bypass, given recent trial findings of improved AKI rates but no significant difference in kidney-replacement therapy with IV amino acids?

Landoni et al., PMID 38865168

1 Answer available

Do you use any urinary staining techniques when performing urine microscopy for patients with acute kidney injury?

1 Answer available

Have you considered priming CRRT machines with renal replacement solutions during the current crystalloid solution shortage?

2 Answers available

What are your top takeaways from ASN 2024?

1 Answer available

How do you determine the optimal time to restart a diuretic in a patient with cirrhosis, ascites, and lower extremity edema who presented with acute kidney injury that resolved with IV albumin and holding diuretics?

1 Answer available

What is your blood pressure or mean arterial pressure goal in a critically ill patient with acute kidney injury?

1 Answer available

Do you avoid performing urine microscopy in patients with AKI who have COVID-19 given concern for potential aerosolization?

2 Answers available

In which clinical scenarios do you use prolonged intermittent renal replacement therapy (PIRRT)?

2 Answers available

Do you avoid terlipressin for patients with hepatorenal syndrome who have a serum sodium level less than 125 mEq/L?

2 Answers available

Do you still consider hepatorenal syndrome in patients with renal impairment and liver disease who are found to have rare muddy brown casts on urine microscopy?

1 Answer available

Do you use terlipressin for patients with hepatorenal syndrome who also have elevated blood pressures?

1 Answer available

Would you recommend initially starting twice-weekly outpatient hemodialysis with close lab monitoring for nonoliguric AKI patients?

3 Answers available

Are there instances when you recommend performing a kidney biopsy in patients with presumed acute interstitial nephritis who are already on steroids and have improving renal function?

2 Answers available

How do you time 24 hour urine collections when calculating creatinine clearance for patients receiving thrice weekly hemodialysis?

2 Answers available

Do you use a phosphate binder to manage inpatient hyperphosphatemia in patients with AKI who have no history of CKD?

5 Answers available

Would you recommend a TIPS procedure in the management of hepatorenal syndrome for a patient with no history of hepatic encephalopathy?

1 Answer available

What is your approach to anticoagulation in a patient with AKI and cirrhosis who has frequent filter clotting on CRRT?

2 Answers available

Do you start patients on a B complex multivitamin if they are on CRRT and have not previous been on renal replacement therapy?

1 Answer available

Do you recommend automatically starting CRRT anticoagulation when initiating CRRT if there are no medical contraindications to anticoagulation?

1 Answer available

Would you recommend delaying left heart catheterization until development of ESKD in a patient with CKD Stage 5 and stable coronary artery disease given concern for contrast-induced nephropathy?

5 Answers available

For patients with suspected complement-mediated TMA, are there specific clinical or laboratory parameters that can help guide the decision for starting empirical treatment (e.g., eculizumab) while awaiting the results of complement testing?

1 Answer available

How do you approach the decision to use terlipressin in a patient with hepatorenal syndrome type 1, AKI, and a history of heart failure given its potential cardiovascular effects?

1 Answer available

For patients on CRRT with worsening hyperkalemia despite high replacement fluid rate using a 0 mEq/L potassium bath, do recommend using an additional CRRT machine with separate dialysis access for improved clearance?

3 Answers available

Do you use serum or urine biomarkers other than creatinine when evaluating patients with acute kidney injury?

3 Answers available

What is your approach to monitoring for recovery in a patient with non-oliguric AKI requiring dialysis?

4 Answers available

Is there benefit to performing CVVH instead of intermittent hemodialysis for a patient with AKI secondary to rhabdomyolysis who requires renal replacement therapy?

1 Answer available

In patients with intrinsic acute kidney injury of unknown etiology and with pending kidney biopsy results, are there instances when you would recommend a trial of glucocorticoids?

1 Answer available

What is your approach to achieving hypernatremia in a patient on CRRT for whom increasing the rate of a post-filter 3% sodium chloride infusion is insufficient?

2 Answers available

Do you recommend holding metformin in a patient with chronic kidney disease who has an upcoming CT contrast study?

3 Answers available

Do you reduce the steroid regimen for patients with acute interstitial nephritis who have a high risk for developing side effects from glucocorticoid therapy?

1 Answer available

Are there instances when you do not perform urine microscopy and rely solely on laboratory performed urinalysis when evaluating a patient for acute kidney injury?

1 Answer available

Are there instances when you use erythropoietin stimulating agents in patients with acute kidney injury requiring dialysis?

2 Answers available

Would you perform dialysis on a patient with altered mental status in the setting of an elevated blood urea nitrogen level attributed to a tube feeding diet?

1 Answer available

Do you hold CRRT for a period of time before performing a diuretic challenge in a patient with whom you are assessing for the ability to wean off of continuous dialysis?

2 Answers available

How long would you wait before performing a kidney biopsy in a patient with possible AIN whose creatinine has plateaued, but not improved, after discontinuing the suspected offending agent?

1 Answer available

Would you recommend giving N-acetylcysteine in addition to holding diuretics in a patient with chronic kidney disease and mild hypervolemia who is planned to have a contrast study?

1 Answer available

When do you restart ACEi/ARB medications for patients whom these medications were previously discontinued due to acute kidney injury?

1 Answer available

Papers discussed in this category

Diabetes Metab, 2021 Dec 13

Acute renal injury events in diabetic patients treated with SGLT2 inhibitors: A comprehensive review with a special reference to RAAS blockers.

The New England journal of medicine, 2018-02-15

Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine.

The New England journal of medicine, 2013 Jul 10

Case records of the Massachusetts General Hospital. Case 23-2013. A 54-year-old woman with abdominal pain, vomiting, and confusion.

Critical care medicine, 2009-09

Discontinuation of continuous renal replacement therapy: a post hoc analysis of a prospective multicenter observational study.

Journal of critical care, 2019-08

The furosemide stress test for prediction of worsening acute kidney injury in critically ill patients: A multicenter, prospective, observational study.

BMC nephrology, 2022 Mar 13

Erythropoietin in Acute Kidney Injury (EAKI): a pragmatic randomized clinical trial.

Current opinion in critical care, 2021 Aug 01

Nutrients and micronutrients at risk during renal replacement therapy: a scoping review.

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 2023 Jan-Dec

Regional Citrate Anticoagulation or Heparin Anticoagulation for Renal Replacement Therapy in Patients With Liver Failure: A Systematic Review and Meta-Analysis.

Kidney international, 2002-11

Microvascular endothelial injury and dysfunction during ischemic acute renal failure.

Medicine, 1979 Sep

The morphology of "acute tubular necrosis" in man: analysis of 57 renal biopsies and a comparison with the glycerol model.

The New England journal of medicine, 2021 Mar 04

Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome.

American journal of infection control, 2020 Jun 02

Cautious handling of urine from moderate to severe COVID-19 patients.

Osong public health and research perspectives, 2020 Feb

Identification of Coronavirus Isolated from a Patient in Korea with COVID-19.

The New England journal of medicine, 2024 Oct 26

Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans.

Atencion primaria, 1997 Sep 30

[The existing differences between adolescent girls served on a first visit in a family planning center in 2 time periods].

The New England journal of medicine, 2024 Oct 25

Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.

The New England journal of medicine, 2024 Jun 12

A Randomized Trial of Intravenous Amino Acids for Kidney Protection.

The New England journal of medicine, 2003 Oct 02

The prevention of radiocontrast-agent-induced nephropathy by hemofiltration.

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