The KDIGO 2012 clinical practice guideline for acute kidney injury (AKI) provides a comprehensive framework for diagnosis, evaluation, and management of AKI. The guideline is based on systematic reviews of evidence and follows the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. It defines AKI as an abrupt decrease in kidney function, including acute renal failure, and outlines staging based on changes in serum creatinine (SCr) levels. The RIFLE system is used for classification, with modifications to include small SCr increases. The guideline emphasizes early detection, risk assessment, and prevention of AKI, as well as management strategies for different stages of the condition. Key recommendations include using isotonic crystalloids over colloids for fluid resuscitation in patients at risk for AKI, avoiding diuretics for prevention or treatment of AKI, and using protocol-based management for hemodynamic and oxygenation parameters in high-risk patients. For nutrition, the guideline suggests maintaining a total energy intake of 20-30 kcal/kg/day and avoiding protein restriction to prevent or delay initiation of renal replacement therapy (RRT). Insulin therapy is recommended for glucose control in critically ill patients, targeting blood glucose levels between 110-149 mg/dl. The guideline also addresses the use of vasodilators, such as dopamine, fenoldopam, and natriuretic peptides, which are not recommended for AKI prevention or treatment. It highlights the risks of aminoglycosides and recommends avoiding them unless no suitable alternatives are available. For surgical patients, off-pump coronary artery bypass graft surgery is not recommended solely for reducing AKI or RRT needs. The guideline emphasizes the importance of early detection, appropriate management, and prevention strategies to improve outcomes and reduce the burden of AKI.The KDIGO 2012 clinical practice guideline for acute kidney injury (AKI) provides a comprehensive framework for diagnosis, evaluation, and management of AKI. The guideline is based on systematic reviews of evidence and follows the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. It defines AKI as an abrupt decrease in kidney function, including acute renal failure, and outlines staging based on changes in serum creatinine (SCr) levels. The RIFLE system is used for classification, with modifications to include small SCr increases. The guideline emphasizes early detection, risk assessment, and prevention of AKI, as well as management strategies for different stages of the condition. Key recommendations include using isotonic crystalloids over colloids for fluid resuscitation in patients at risk for AKI, avoiding diuretics for prevention or treatment of AKI, and using protocol-based management for hemodynamic and oxygenation parameters in high-risk patients. For nutrition, the guideline suggests maintaining a total energy intake of 20-30 kcal/kg/day and avoiding protein restriction to prevent or delay initiation of renal replacement therapy (RRT). Insulin therapy is recommended for glucose control in critically ill patients, targeting blood glucose levels between 110-149 mg/dl. The guideline also addresses the use of vasodilators, such as dopamine, fenoldopam, and natriuretic peptides, which are not recommended for AKI prevention or treatment. It highlights the risks of aminoglycosides and recommends avoiding them unless no suitable alternatives are available. For surgical patients, off-pump coronary artery bypass graft surgery is not recommended solely for reducing AKI or RRT needs. The guideline emphasizes the importance of early detection, appropriate management, and prevention strategies to improve outcomes and reduce the burden of AKI.