Acute Kidney Injury Part 1:
- Scrutinise the notes, drug charts and review the history.
- Fully examine the patient.
- Look for infection and treat it.
- Examine the urine: proteinuria and haematuria may indicate glomerulonephritis and urgent renal referral is obligatory. Look for skin rash, nail changes, arthralgia and history of rigors.
- Early diagnosis and appropriate treatment such as immunosuppression/plasma exchange may save renal function therefore always consider early discussion with the renal team. GN bloods include anti-nuclear factor, anti neutrophil cytoplasmic antibody, anti-glomerular basement membrane antibody, rheumatoid factor.
- Fluid balance: once volume depletion corrected, and in the absence of fluid overload, give previous hour’s output (urine and other losses) plus insensible (about 20-40ml/hr).