Aim to achieve and maintain optimal fluid status (euvolaemia) in all patients.
- If there is volume depletion (hypovolaemia), and fluid needs cannot be met orally or enterally, give patients intravenous fluids as part of a protocol to restore and maintain optimal fluid status.
- Monitor renal function every 24-28 hours when unwell
- Ensure patients have an intravenous fluid management plan that is reviewed daily
- Base choice of fluids on biochemistry results and fluid status
Consider reviewing medication than can cause or worsen AKI
- Consider stopping usual diuretics if euvolamic with high insensible losses
- Withhold medication that can cause or worsen AKI, unless essential
- See below for ACEi/ARB advice
Avoid fluid boluses if normotensive
See NICE guidance here.