Acute Kidney Injury in Sepsis

Diagnostic Criteria

The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines define Acute Kidney Injury (AKI) as an increase in serum creatinine by ≥0.3 mg/dl (≥26 mmol/l) within 48 hours, or an increase in serum creatinine to ≥1.5 times baseline within 7 days, or a urine volume of <0.5 ml/kg/h for 6 hours 1
Volume depletion, such as from decreased oral intake, fever, or insensible losses, can contribute to AKI, as defined by the KDIGO guidelines 1
Contrast-induced nephropathy should be considered if recent imaging studies with contrast were performed, according to the KDIGO guidelines 1

The use of vasopressors, such as norepinephrine, may be necessary for hemodynamic support in patients with sepsis-associated AKI, as recommended by the Intensive Care Medicine guidelines 2
Renal replacement therapy (RRT) should be considered if severe AKI develops, with either continuous or intermittent RRT being used, and continuous therapies being preferred in hemodynamically unstable patients, according to the Intensive Care Medicine guidelines 2
RRT should not be initiated solely for oliguria or creatinine elevation without other indications, as stated in the Intensive Care Medicine guidelines 2