Prevention of Acute Kidney Injury in People with Diabetes in the Intensive Care Unit

Abstract

Prevention of acute kidney injury (AKI) in the intensive care unit (ICU) is a management strategy with a multidisciplinary approach. Sepsis being the most common cause requires immediate treatment with antimicrobials. Other causes such as cardiogenic shock, postoperative cause, and drug-induced injury are not infrequent in diabetic patients. Control of blood sugar and accompanying electrolyte abnormalities requires expertise. Contrast use is necessary in ICU patients which adds insult to the injury. A point-of-care ultrasound is a mandatory imaging for evaluation of the kidneys and to assess for inferior vena cava collapsibility. Nutrition plays an important component of the therapy, and fluid replacement and the use of vasopressors are necessary. Cardiac support with an intra-aortic balloon pump and extracorporeal membrane oxygenation with the ventricular-assisted device is necessary in maintaining hemodynamic status. Artificial intelligence and a new technological approach with a multidisciplinary team comprising a nephrologist, intensivist, cardiologist, hepatologist, infectious disease specialist, and nutritionist work as a team in preventing AKI in People with diabetes in the ICU.