Management of Acute Kidney Injury in Patients with Campylobacter and Rotavirus Infections

Immediate Assessment and Diagnostic Workup

The American College of Physicians recommends obtaining urgent renal ultrasound to exclude obstructive uropathy, and measuring serum creatinine, urea, and electrolytes at least every 48 hours, or more frequently if clinically unstable 3
The British Medical Journal suggests obtaining urinalysis looking for hematuria, proteinuria, and casts to differentiate prerenal from intrinsic renal causes, and monitoring hourly urine output with bladder catheter placement in severe cases 1, 3

The British Medical Journal recommends assessing fluid status by clinical examination and aggressively resuscitating with intravenous crystalloids if volume depleted, using balanced crystalloid solutions to avoid hyperchloremic acidosis 1, 3
The Kidney International journal suggests maintaining optimal fluid status, avoiding fluid overload, and considering early renal replacement therapy for fluid removal rather than continuing aggressive fluid administration 3, 4, 5

The American College of Cardiology recommends stopping NSAIDs immediately, holding ACE inhibitors and ARBs during the acute phase, and discontinuing metformin if GFR <30 ml/min/1.73m², as well as reviewing and stopping all potentially nephrotoxic medications 1, 2
The Praxis Medical Insights guideline suggests adjusting antibiotic doses based on current GFR, avoiding trimethoprim-sulfamethoxazole if creatinine clearance <15 ml/min, and monitoring therapeutic drug levels for medications with narrow therapeutic windows 1, 2, 6

The Centers for Disease Control and Prevention recommends that most Campylobacter enteritis is self-limited and does not require antibiotics in immunocompetent patients, but if antibiotics are indicated, adjust doses for renal function and obtain stool culture to guide therapy 7
The MMWR Recommendations and Reports suggests that rotavirus treatment is supportive with oral or intravenous rehydration 7

The British Medical Journal recommends monitoring potassium levels at least daily, managing hyperkalaemia according to local protocols, and considering potassium binders alongside standard care for acute life-threatening hyperkalaemia 3
The BMJ also suggests monitoring bicarbonate levels as part of electrolyte panel, and being aware of rotavirus-associated uric acid nephropathy presenting with normal anion gap metabolic acidosis from proximal tubular injury (Fanconi syndrome) 3, 8

The British Medical Journal recommends referring for specialist nephrology consultation if there is diagnostic uncertainty about AKI cause, abnormal urinalysis suggesting intrinsic renal disease, AKI worsening despite initial management, or oliguria/anuria persisting despite adequate fluid resuscitation, as well as usual indications for renal replacement therapy 3, 5