Management (general and specific)
Management of AKI – the 3Ms – Monitor, Maintain and Minimise
Children at risk of AKI or with confirmed AKI should be managed using the following iterative steps to prevent further harm [12]:
| 1) MONITOR | Children should have urea and electrolytes and creatinine checkedFluid balance
● Fluid inputs ● urine output, ● Weight recorded Urinalysis performed Blood pressure Paediatric Early Warning Score (EWS) Any signs of sepsis should be urgently investigated and treated. |
| 2) MAINTAIN CIRCULATION | Urgently address hypoperfusion using with fluid boluses of normal salineGive maintenance fluids and replace ongoing losses (eg diarrhoea) |
| 3) MINIMISE KIDNEY INJURY | Reduce further harm by reviewing, adjusting and monitoring medication that may adversely affect renal function (see next section) |