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Topics:
Nephrology • Acute kidney injury
Do you recommend IV sodium bicarbonate for patients with rhabdomyolysis and AKI without metabolic alkalosis or hypocalcemia?
Answer from: at Community Practice
The primary goal of IV fluids and urine alkalinization in patients with rhabdomyolysis is to prevent AKI, not to treat established AKI. The most important factor in preventing AKI is early and vigorous fluid administration (aiming to achieve a brisk diuresis of 200-400 ml/hr), while the choice of IV...
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Answer from: at Academic Institution
No. There is no clear clinical evidence demonstrating that an alkaline diuresis is more effective than a saline diuresis in the prevention and treatment of AKI in the setting of rhabdomyolysis given the lack of direct comparative trial. Therefore, aggressive saline hydration is typically recommen...