Figure 6 Approach to drug management in patients with acute kidney disease (AKD) Figure 6 | Approach to drug management in patients with acute kidney disease.

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Figure 6 Approach to drug management in patients with acute kidney disease (AKD) Figure 6 | Approach to drug management in patients with acute kidney disease (AKD). AKD can have various clinical courses and clinicians will be tasked with deciding when to change the dose, discontinue, and potentially re-introduce medications that are affected by kidney function and/or that are nephrotoxic. Assessment of renal function with use of biomarkers, glomerular filtration rate (GFR) measurement, and imaging should be performed across all stages of AKD as clinically indicated. Different possible scenarios are illustrated as follows: AKD begins to improve early in the clinical course (1); AKD is more entrenched, and kidney function improves only after a considerable decline in kidney function (2); AKD takes a severe course with kidney function recovery occurring after an extended decline in kidney function (3); severe AKD with progression to renal replacement therapy (4). Modified from Acute Dialysis Quality Initiative 16; www.adqi.org. Modified from Acute Dialysis Quality Initiative 16; www.adqi.org. Chawla, L. S. et al. (2017) Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup Nat. Rev. Nephrol. doi:10.1038/nrneph.2017.2