Acute Kidney Injury

The treatment of Acute Kidney Injury (AKI) has changed dramatically with the change in the management of comorbidities associated with it, such as hypertension. With this change, the rationale applied in the approach taken to treat these changes has also evolved. The use of pharmacologic treatment of AKI has been tried with varying success rates due to inefficiencies in implementing approaches used in trials with animals in humans or the effectiveness of some of the tries (1). Some of the experimental therapies used today are hypoperfusion, and the preventative intervention has been the intravenous administration of isotonic saline (3). The lack has informed intravascular volume expansion using isotonic saline of sufficient evidence that colloids are more effective for this purpose and evidence that some colloids may result in AKI. The high cost of colloids also limits their use.

Action Mechanisms of the Drugs Used for Treatment

In some patients, colloids are used to reach resuscitation or to avoid excessive administration of fluids or among cirrhotic patients who have spontaneous peritonitis. Hypertonic or hypnotic crystalloids may be applied in ideal clinical scenarios where the selected crystalloid with altered tonicity is dictated by other goals rather than intravascular volume expansion, such as hyponatremia or hypernatremia. Isotonic solutions have 154 mmol/l Chloride and, when administered in large amounts, may result in obsolete or relative hyperchloremia (6). The buffered saline solution approximates the concentration of physiological chloride and causes a decline in the acid-base distribution. Once the intravascular volume is optimized, it is uncertain which vasopressor agent is the most suitable for managing shock since there are negligible differences between renal mortality and function (4). However, Vasopressin is gaining preference compared to norepinephrine since it enhances diuresis and increases blood pressure but is yet proven to enhance survival.

Appropriate vasoactive agents can improve kidney perfusion among patients in volume-restricted who have a vasomotor shock. The lack of protocolized therapies and standardized care has an array that limits the efficacy of using postoperative therapies. Insufficient management strategies, standardized hemodynamic, and tissue oxygenation targets to assess the efficacy of the protocolized therapies compared...…20% mannitol before the vessel cramp during renal transplant served a preventative function (6). Further, it reduced post-transplant incidences of AKI.

Further, its administration in rhabdomyolysis is beneficial since it stimulates osmotic diuresis and lowers the intercompartmental pressure in the affected limbs. However, the use of a low dosage of dopamine is recommended for patients who are diagnosed with Grade 1 AKI. The use of diuretics to prevent AKI Grade 1B should be avoided. However, they may be used to treat volume overload among AKI Grade 2C patients.

Dosages and Routes of Drugs Administration

For patients with a Grade 2 AKI, aminoglycosides should be used to treat infections unless they are not suitable, less nephrotoxic, therapeutic alternatives are available. They should be administered once a day, and therapeutic drug monitoring should be exercised (6). The peak drug level should be maintained at 10-fold more than the minimum inhibitory concentration involving the infecting microorganism in extended-dose or single-dose treatment strategies. Among critically ill patients, a single dose of theophylline may be administered in neonates with severe perinatal asphyxia that…