Show 3 more Prevention of cardiac surgery-associated AKI (prevention, cardiopulmonary bypass strategies): avoid administering hyperthermic perfusion (> 37 C) to reduce the risk of cardiac surgery-associated AKI in adult patients undergoing cardiac surgery with cardiopulmonary bypass. D Show 2 more Prevention of cardiac surgery-associated AKI (prevention, minimally invasive extracorporeal circulation): consider using minimally invasive extracorporeal circulation techniques to minimize the risk of cardiac surgery-associated AKI in adult patients undergoing cardiac surgery with cardiopulmonary bypass. C Measures with no evidence for benefit: As per JSN 2018 guidelines: Do not use loop diuretics D or low-dose dopamine for the prevention of AKI. D Insufficient evidence to support the use of low-dose atrial natriuretic peptide for the prevention of AKI. I Do not use diuretics, D low-dose dopamine, D or recombinant human IGF-1 for the prevention of AKI. D Show 2 more Landmark trials: Low-dose dopamine in patients with early renal dysfunction In critically ill patients at risk of renal failure, low-dose dopamine was not superior to placebo with respect to peak serum creatinine concentration. Bellomo R et al. Lancet. 2000 Dec 23-30. 10. Follow-up and surveillance Discharge from hospital: include a record in the discharge summary regarding AKI detected whilst in hospital, its maximum stage, etiology, the need for renal support (temporary/ongoing), and discharge renal function, if dialysis-independent. B Show 2 more Follow-up: As per UKKA 2019 guidelines: https://web.pathway.md/diseases/recRY6zuQyeq4bFgI 15/19 6/23/23, 1:57 AM Acute kidney injury Pathway Obtain serum creatinine and potassium measurement 1-2 weeks after restarting potential culprit drugs after an episode of AKI and after any subsequent dose titration. B Arrange a formal post-discharge nephrology visit as follows: Situation Guidance Residual CKD stage G4 at hospital discharge Within 90 days Within 30 days Residual CKD stage G5 (non-dialysis- requiring) at hospital discharge Within 30 days. B Ongoing dialysis requirements at the time of hospital discharge As per JSN 2018 guidelines, consider confirming the patient's condition approximately 3 months later and obtaining long-term follow-up in accordance with their condition. C As per ERBP 2012 guidelines, assess patients 2 months after AKI to evaluate the completeness of resolution, and to detect new-onset CKD or worsening of preexisting CKD. B As per KDIGO 2012 guidelines, evaluate patients 3 months after AKI for resolution, new onset, or worsening of preexisting CKD. References 1. Arif Khwaja. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120 4):c179 84. Open 2. Michael Joannidis, Wilfred Druml, Lui G Forni et al. Prevention of acute kidney injury and protection of renal function in the intensive care unit. Expert opinion of the Working Group for Nephrology, ESICM. Intensive Care Med. 2010 Mar;36 3 392 411. Open 3. Suren Kanagasundaram, Caroline Ashley, Sheetal Bhojani et al. Clinical Practice Guideline Acute Kidney Injury. UKKA. 2019 Aug. Open 4. Ad-hoc working group of ERBP, Danilo Fliser, Maurice Laville et al. A European Renal Best Practice ERBP position statement on the Kidney Disease Improving Global Outcomes KDIGO clinical practice guidelines on acute kidney injury: part 1 definitions, conservative management and contrast-induced nephropathy. Nephrol Dial Transplant. 2012 Dec;27 12 4263 72. Open 5. Jeremiah R Brown, Robert A Baker, Linda Shore-Lesserson et al. The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society for Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery-Associated Acute Kidney Injury. Anesth Analg. 2023 Jan 1;136 1 176 184. Open 6. D. Blair Macdonald, MD, FRCPC et al. Canadian Association of Radiologists Guidance on Contrast Associated Acute Kidney Injury. CAR. 2022 May. Open 7. Kent Doi, Osamu Nishida, Takashi Shigematsu et al. The Japanese clinical practice guideline for acute kidney injury 2016. Clin Exp Nephrol. 2018 Oct;22 5 985 1045. Open https://web.pathway.md/diseases/recRY6zuQyeq4bFgI 16/19 6/23/23, 1:57 AM Acute kidney injury Pathway 8. Jean-Philippe Collet, Holger Thiele, Emanuele Barbato et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021 Apr 7;42 14 1289 1367. Open 9. National Institutes of Health. Coronavirus Disease 2019 COVID 19 Treatment Guidelines. National Institutes of Health. 2021 Oct. Open 10. Mitra K Nadim, Lui G Forni, Ravindra L Mehta et al. COVID 19-associated acute kidney injury: consensus report of the 25th Acute Disease Quality Initiative ADQI Workgroup. Nat Rev Nephrol. 2020 Dec;16 12 747 764. Open 11. Lakhmir S Chawla, Rinaldo Bellomo, Azra Bihorac et al. Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative ADQI 16 Workgroup. Nat Rev Nephrol. 2017 Apr;13 4 241 257. Open 12. Marlies Ostermann, Alexander Zarbock, Stuart Goldstein et al. Recommendations on Acute Kidney Injury Biomarkers From the Acute Disease Quality Initiative Consensus Conference: A Consensus Statement. JAMA Netw Open. 2020 Oct 1;3 10):e2019209. Open 13. Mikhail C.S.S. Higgins, MD, MPHa et al. ACR Appropriateness Criteria Dialysis Fistula Malfunction. ACR. 2023. Open 14. Expert Panel on Urologic Imaging, Jade J Wong-You-Cheong, Paul Nikolaidis et al. ACR Appropriateness Criteria Renal Failure. J Am Coll Radiol. 2021 May;18 5S S174 S188. Open 15. Rex O Brown, Charlene Compher, American Society for Parenteral and Enteral Nutrition Board of Directors. A.S.P.E.N. clinical guidelines: nutrition support in adult acute and chronic renal failure. JPEN J Parenter Enteral Nutr. 2010 Jul-Aug;34 4 366 77. Open 16. Steven L Flamm, Florence Wong, Joseph Ahn et al. AGA Clinical Practice Update on the Evaluation and Management of Acute Kidney Injury in Patients With Cirrhosis: Expert Review. Clin Gastroenterol Hepatol. 2022 Dec;20 12 2707 2716. Open 17. V Riambau, D B ckler, J Brunkwall et al. Editor's Choice Management of Descending Thoracic Aorta Diseases: Clinical Practice Guidelines of the European Society for Vascular Surgery ESVS . Eur J Vasc Endovasc Surg. 2017 Jan;53 1 4 52. Open 18. Makris K, Spanou L. Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. Clin Biochem Rev. 2016 May;37 2 85 98. Open 19. Kashani K, Shao M, Li G et al. No increase in the incidence of acute kidney injury in a population-based annual temporal trends epidemiology study. Kidney Int. 2017 Sep;92 3 721 728. Open 20. Bouchard J, Mehta RL. Acute Kidney Injury in Western Countries. Kidney Dis Basel). 2016 Oct;2 3 103 110. Open 21. Hoste EAJ, Kellum JA, Selby NM et al. Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol. 2018 Oct;14 10 607 625. Open 22. STARRT AKI Investigators. STandard versus Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury: Study Protocol for a Multi-National, Multi-Center, Randomized Controlled Trial. Can J Kidney Health Dis. 2019 Jun 10;6 2054358119852937. Open 23. STARRT AKI Investigators, Canadian Critical Care Trials Group, Australian and New Zealand Intensive Care Society Clinical Trials Group et al. Timing of Initiation of Renal-Replacement Therapy in Acute Kidney https://web.pathway.md/diseases/recRY6zuQyeq4bFgI 17/19 6/23/23, 1:57 AM Acute kidney injury Pathway Injury. N Engl J Med. 2020 Jul 16;383 3 240 251. Open 24. Saber D Barbar, Rapha l Clere-Jehl, Abderrahmane Bourredjem et al. Timing of Renal-Replacement Therapy in Patients with Acute Kidney Injury and Sepsis. N Engl J Med. 2018 Oct 11;379 15 1431 1442. Open 25. Rafidah Atan, Leah Peck, John Prowle et al. A Double-Blind Randomized Controlled Trial of High Cutoff Versus Standard Hemofiltration in Critically Ill Patients With Acute Kidney Injury. Crit Care Med. 2018 Oct;46 10):e988-e994. Open 26. Wesley H Self, Matthew W Semler, Jonathan P Wanderer et al. Balanced Crystalloids versus Saline in Noncritically Ill Adults. N Engl J Med. 2018 Mar 1;378 9 819 828. Open 27. Melanie Meersch, Mira K llmar, Christoph Schmidt et al. Long-Term Clinical Outcomes after Early Initiation of RRT in Critically Ill Patients with AKI. J Am Soc Nephrol. 2018 Mar;29 3 1011 1019. Open 28. Sean M Bagshaw, R T Noel Gibney, Peter Kruger et al. The effect of low-dose furosemide in critically ill patients with early acute kidney injury: A pilot randomized blinded controlled trial (the SPARK study). J Crit Care. 2017 Dec;42 138 146. Open 29. Estelle C Nijssen, Roger J Rennenberg, Patty J Nelemans et al. Prophylactic hydration to protect renal function from intravascular iodinated contrast material in patients at high risk of contrast-induced nephropathy AMACING a prospective, randomised, phase 3, controlled, open-label, non-inferiority trial. Lancet. 2017 Apr 1;389 10076 1312 1322. Open 30. RENAL Replacement Therapy Study Investigators, Rinaldo Bellomo, Alan Cass et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med. 2009 Oct 22;361 17 1627 38. Open 31. Alexander Zarbock, John A Kellum, Christoph Schmidt et al. Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury: The ELAIN Randomized Clinical Trial. JAMA. 2016 May 24 31;315 20 2190 9. Open 32. St phane Gaudry, David Hajage, Fr derique Schortgen et al. Initiation Strategies for Renal- Replacement Therapy in the Intensive Care Unit. N Engl J Med. 2016 Jul 14;375 2 122 33. Open 33. Paul Young, Michael Bailey, Richard Beasley et al. Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit: The SPLIT Randomized Clinical Trial. JAMA. 2015 Oct 27;314 16 1701 10. Open 34. Zhiping Sun, Hong Ye, Xia Shen et al. Continuous venovenous hemofiltration versus extended daily hemofiltration in patients with septic acute kidney injury: a retrospective cohort study. Crit Care. 2014 Apr 9;18 2 R70. Open 35. VA/NIH Acute Renal Failure Trial Network, Paul M Palevsky, Jane Hongyuan Zhang et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med. 2008 Jul 3;359 1 7 20. Open 36. Jos Ant nio Lopes, Sofia Jorge. The RIFLE and AKIN classifications for acute kidney injury: a critical and comprehensive review. Clin Kidney J. 2013 Feb;6 1 8 14. Open 37. Kathleen D. Liu, MD, PhD et al. Curbing the Use of Ultrasonography in the Diagnosis of Acute Kidney Injury. Arch Intern Med. 2010 Nov 22; 170 21 1907 1908. Open https://web.pathway.md/diseases/recRY6zuQyeq4bFgI 18/19 6/23/23, 1:57 AM Acute kidney injury Pathway 38. Fernando G Zampieri, Fl via R Machado, Rodrigo S Biondi et al. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill Patients: The BaSICS Randomized Clinical Trial. JAMA. 2021 Aug 10;326 9 1 12. Open 39. Laurent Brochard, Fekri Abroug, Matthew Brenner et al. An Official ATS/ERS/ESICM/SCCM/SRLF Statement: Prevention and Management of Acute Renal Failure in the ICU Patient: an international consensus conference in intensive care medicine. Am J Respir Crit Care Med. 2010 May 15;181 10 1128 55. Open https://web.pathway.md/diseases/recRY6zuQyeq4bFgI 19/19