genitourinary disorders
Acute Kidney Injury (AKI)
Prevention of AKI
Acute kidney injury (AKI) can often be prevented by maintaining normal fluid balance, blood volume, and blood pressure in patients with trauma, burns, or severe hemorrhage and in those undergoing major surgery. Infusion of isotonic saline and blood may be helpful. before and after contrast administration has also been used successfully instead of normal saline, especially in patients with concurrent Metabolic Acidosis . Before cytolytic therapy is initiated in patients with certain neoplastic diseases (eg, lymphoma, leukemia), treatment withrasburicaseorallopurinolshould be considered along with increasing urine flow by increasing oral or IV fluids to reduce urate crystalluria. Making the urine more alkaline (by giving oral or IVsodium bicarbonateoracetazolamide) has been recommended by some but is controversial because it may also induce urinarycalcium phosphateprecipitation and crystalluria, which may worsen AKI. 