Stop all potentially nephrotoxic drugs (ACEi, ARB, NSAIDs, COX II inh..).
Withhold all anti-hypertensives if hypotensive.
Treat sepsis with appropriate antibiotics (avoid gentamicin, trimethoprim & cotrimoxazole – use antibiotic man or discuss with micro/ID).
Adjust essential drugs appropriately for renal function (check the BNF).
AVOID CONTRAST INDUCED NEPHROPATHY.
RELIEVE URINARY TRACT OBSTRUCTION – Catheter or nephrostomy.
INDICATIONS FOR RENAL REFERRAL (Bleep 4740)
-
- All AKI 3
- Hyperkalaemia (K+ >6.5)*
- Resistant Pulmonary oedema
- AKI with low platelets (?HUS)
- Persistent oliguria or ongoing deterioration despite above measures
- Suspicion of intrinsic renal disease e.g. vasculitis
Renal team are happy to advise regarding any concerns.
