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) |