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Managing AKI Stages 2 or 3

AKI, acute kidney injury; HRS, hepatorenal syndrome
If AKI Stage 2 or 3 is diagnosed: Implement risk factor management if applicable
AND
implement the albumin challenge (albumin 1g/kg for 2 days).
Assess for one of the following scenarios:
Cirrhosis with ascites
AKI according to the International Club of Ascites-Acute Kidney Injury criteria
No response after 2 consecutive days of diuretic withdrawal and plasma volume expansion with albumin infusion (1 g/kg body weight per day)
Absence of shock
No current or recent use of nephrotoxic drugs (NSAIDs, aminoglycosides, or iodinated contrast media)
No signs of structural kidney injury, as indicated by proteinuria (> 500 mg per day), microhematuria (> 50 red blood cells per high-power field), and/or abnormal renal ultrasonography
Increase in SCr ≥ 0.3 mg/dL from the baseline within 48 h or a percent increase in SCr of ≥ 50%, which is known or presumed to have occurred within the preceding 7 days
AKI, acute kidney injury; NSAIDs, nonsteroid anti-inflammatory drugs