Drugs to be used in Acuke Kidney Injury

In Acute Kidney Injury (AKI), the primary goal is to manage the underlying cause and support kidney function. Medications are used cautiously and often adjusted based on the severity of AKI and electrolyte levels. 1. Diuretics: If the patient is fluid overloaded and producing little urine (oliguria or anuria), loop diuretics like furosemide may be used to help remove excess fluid and improve urine output. However, they do not improve kidney function itself and can cause dehydration if not managed carefully. 2. Electrolyte Management: Hyperkalemia Treatment: If potassium levels are dangerously high, medications like calcium gluconate (to stabilize the heart), insulin and glucose (to shift potassium into cells), sodium polystyrene sulfonate (Kayexalate), or patiromer* (to remove potassium from the gut) may be used. Metabolic Acidosis Treatment: If there is severe metabolic acidosis (low bicarbonate), sodium bicarbonate* may be administered. 3. Phosphate Binders: For patients with hyperphosphatemia (high phosphate), phosphate binders like calcium acetate or sevelamer might be prescribed. 4. Dopamine (Low Dose): Historically, low-dose dopamine was sometimes used for its potential "renal protective" effects, but current evidence does not strongly support its routine use in AKI and it can have adverse cardiovascular effects. 5. Renal Replacement Therapy (Dialysis): This is not a drug, but it is a critical intervention for severe AKI when conservative management fails. It effectively removes waste products, excess fluid, and electrolytes. It's important to note that many drugs need dose adjustments in AKI because their excretion is impaired. Always consult a healthcare professional for specific medical advice. What's next?