In this short lecture, we walk through the major updates in the KDIGO 2026 Clinical Practice Guideline Draft for Acute Kidney Injury (AKI) and Acute Kidney Disease (AKD), focusing specifically on what has changed for adult patients compared to the older 2012 KDIGO AKI guideline.

Topics covered:

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Expanded AKI and AKD definitions (Cystatin C, structural biomarkers, transient vs. persistent AKI)

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The new 3-axis staging system (C, U, B)

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Diagnostic pitfalls (electronic alerts, FeNa, urine eosinophils) and new biomarkers (CXCL9)

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Fluids and diuretics paradigm shift (buffered crystalloids, CA-AKI prevention)

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Hemodynamic targets, glucose targets, and kidney protection bundles

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HRS vasoconstrictors and TLS rasburicase recommendations

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Medication management: 4-quadrant drug classification, nephrotoxin stewardship, sick day protocols

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RRT timing (deferred strategy), citrate anticoagulation, and discontinuation criteria

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Post-AKI follow-up: KAMPS framework and WATCH-ME framework

Medical Disclaimer: This content is for educational and informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider.

Reference:
KDIGO 2026 Clinical Practice Guideline for Acute Kidney Injury and Acute Kidney Disease — Public Review Draft, March 2026.
Available at: https://kdigo.org

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