Positive test (> 0.3) | Negative test (≤ 0.3) |
---|---|
• Discontinue all nonessential nephrotoxins (e.g., NSAIDs) • Avoid vancomycin or dose adjust • Goal-directed fluid/diuretic management* | • Standard of care or fast-track • Repeat [TIMP-2]•[IGFBP7] test if additional exposures occur • Consider diuretics to maintain fluid balance |
• Discontinue all ACE inhibitors and/or ARBs • Maintain close UO monitoring • Review meds with clinical pharmacist • Retain invasive hemodynamic monitoring • Avoid saline | |
• Consult nephrology • Repeat [TIMP-2]•[IGFBP7] test in 12–24 h • Consult intensive care |