What is your approach to monitoring for recovery in a patient with non-oliguric AKI requiring dialysis?

In my opinion, the best test to monitor the recovery of renal function in an AKI patient is a daily measurement of serum creatinine. Decreasing serum creatinine is the most reliable marker to indicate recovery of kidney function after AKI.

The main confounder would be simultaneous loss of muscle mass but this would have to be extremely profound to affect serum creatinine on a daily basis.

Even though non-oliguric patients with AKI are still making urine, it is usually the case that once renal function starts to improve the first sign is an increase in the urine volume. Making monitoring of daily urine volumes is still very important. Often, when patients are starting to recover from renal failure they are no longer on CRRT but on intermittent hemodialysis. This allows the nephrologist to watch the serum BUN and creatinine trend after the day patient did not get dialysis. Of cours...

My usual standard for stopping dialysis in patients with AKI on intermittent HD is to check the serum creatinine on an inter-dialytic day and the next day, pre-dialysis. if the value has fallen or remains the same, I’ll stop and monitor. In my experience stopping dialysis when urine output recovers usually is a bit too soon. Obviously, you can’t be too rigid about these things. I may continue a while for patients with marked volume overload, and so forth

Agree with Dr. @Dr. First Last. The real issue is not recognizing recovery because you just scan the monthly labs. Patients often get discharged to a dialysis unit we do not cover and so I tell the patient to remind their nephrologist that we thought there was a good chance they may come off dialysis and to look closely. I have seen several patients (not ours) on dialysis in the hospital with very low creatinine values that just don't look like they could possibly need dialysis, so we hold it fo...