What are the recommended management strategies for a patient diagnosed with AKI, particularly regarding fluid management and medication adjustments?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Fluid management in acute kidney injury: Monitor serum creatinine regularly and assess clinical need to guide fluid management, with daily measurement typical in hospital settings .

Consider cautious fluid resuscitation to maintain adequate perfusion, but avoid fluid overload, which can worsen pulmonary oedema and other complications .

Medication adjustments: Reconsider the use of potentially nephrotoxic drugs, including NSAIDs, aminoglycosides, ACE inhibitors, ARBs, and diuretics, and consider temporarily stopping these medications until renal function stabilizes , .

Seek advice from a pharmacist about optimizing medicines and drug dosing in patients with or at risk of AKI .

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