Trigger
- Urine output < 0.5 mL/kg/hr
- Creatinine rising over 24-48h
Assess
- Volume status and MAP
- Medication review (nephrotoxins)
- Bladder scan / obstruction check
Initial actions
- Restore perfusion if hypovolemic
- Hold ACEi/ARB/NSAIDs if acute
- Avoid further contrast exposure
Investigate
- Urinalysis and microscopy
- Electrolytes, urea, creatinine trend
- Consider renal ultrasound if obstructed
Reassess
- Urine output response over 4-6h
- Escalate if worsening or refractory
Educational reference only. Not a substitute for clinical guidelines or supervision.