AKI/AKD 90-Day Recovery Planner W.G.M. Rivero MD · FPCP · DPSN · · renalcarematters.com · 2026
A Shared Patient + Clinician Tool · AKI Recovery
AKI/AKD 90-Day Recovery Planner
Fill this in with your clinician. It records your baseline, your recovery trajectory, and a clinician-approved plan for every medicine — through Day 90.
🫘
W.G.M. Rivero MD
FPCP · DPSN
Nephrologist
renalcarematters.com
0–90
Days: the recovery window after AKI
Day 90
Check both kidney function AND damage
Every med
Has a named prescriber & monitoring date
1My Kidney Event & Clinician Handoff
Patient name / identifier
Preferred contactAdmission date
Discharge dateAKI stage (1 / 2 / 3 / unknown)
Suspected cause(s) of AKI — tick all that apply
Sepsis / infection   Dehydration / GI loss   Heart failure   Surgery   Obstruction   Medication / toxin   Dengue   Leptospirosis   Glomerular disease   Pregnancy-related   Other / uncertain
Baseline SCr / eGFR & date Baseline uncertain?Yes — baseline unknown
Peak SCr & date Lowest urine output (if known)
Kidney replacement therapy (KRT / dialysis) used?
No    Yes — modality            , start date         , last treatment            or ongoing
Discharge numbers
SCr / eGFRPotassium (K)
Bicarbonate (HCO₃ / total CO₂)Blood pressure (BP)
Weight / volume statusUrine output & date
Recovery category
KDIGO 2026 draft definition		 Complete   Partial   Not resolved   Indeterminate
Named follow-up clinician / team & contact
Nephrotoxins / exposures to avoid
This is a clinician–patient shared document, not a self-treatment protocol. Every medication action in this planner needs a named prescriber. Do not start, stop, or change any prescription medicine on your own. Recovery definitions marked "draft" come from the March 2026 KDIGO AKI/AKD public-review draft and are proposed, not final.
For educational use only. This planner does not replace individualized medical advice. It is completed together with your clinician, who owns every medication and monitoring decision. renalcarematters.com
Page 1 of 8 · renalcarematters.com/guides/aki-does-not-end-at-discharge.html
My 0–90-Day Recovery Road Map
Milestones from discharge to the Day-90 decision · fill in your own dates
 Page 2 of 8 · renalcarematters.com

Your clinician decides which reviews you need and when. Earlier review is for higher-risk recovery; everyone with a meaningful AKI needs the Day-90 check. Write your planned date, place, and clinician for each milestone, then tick it off when done.

Day 0 · Discharge
Passport complete; medicines and follow-up plan in hand.
Date
Done
Days 1–7 · Safety check
Volume, BP, potassium, medicine tolerance. Home monitoring daily.
Date Clinician
Done
Days 7–14 · Early review
For higher-risk patients (stage 2–3, KRT, HF, dynamic labs, meds restarted).
Date Clinician
Done
Day 30 · Trajectory & meds
Repeat kidney function; titrate and monitor indicated medicines.
Date Clinician
Done
Day 60 · Unresolved-AKD checkpoint
If still abnormal (AKD), reassess actively — do not just wait for Day 90.
Date Clinician
Done
Day 90 · The decision
Kidney function + kidney damage + CKD decision (see page 8).
Date Clinician
Done
MilestonePlanned dateLocationClinicianLabs before visit / result & action
Days 1–7
Days 7–14
Day 30
Day 60
Day 90
Feeling better is not the same as completing follow-up. Keep every appointment even if you feel well.
For educational use only. Follow-up timing is individualized by your clinician; these bands are a planning aid, not a triage rule. renalcarematters.com · Page 2 of 8
Laboratory & Kidney-Health Tracker
One row per blood draw · compare against YOUR baseline, not just the lab's "normal"
 Page 3 of 8 · renalcarematters.com
Timepoint Date SCr (mg/dL) eGFR · steady? (Y/N/?) Cystatin C K · HCO₃ · Na UACR / UPCR Urinalysis / blood 24-h urine / clearance (if AKI-D) · clinician note
Baseline
Peak (worst)
Discharge
Day 7
Day 14
Day 30
Day 60
Day 90
Other
Other

How to read this tracker

eGFR is only reliable when creatinine is steady — mark "N" or "?" if it is still rising or falling fast, and treat that eGFR as informational only. Do not colour a single creatinine "green" without looking at your baseline and the trend. A urine test for protein (UACR) matters even when creatinine improves. Optional unit note: 1 mg/dL creatinine = 88.4 µmol/L.

SCr = serum creatinine · eGFR = estimated glomerular filtration rate · UACR = urine albumin-to-creatinine ratio · UPCR = urine protein-to-creatinine ratio. Educational use only. renalcarematters.com · Page 3 of 8
Medication Stop / Restart / Review Plan
Every line needs a named prescriber and a monitoring date · never self-adjust
 Page 4 of 8 · renalcarematters.com
Medicine (generic / brand) Original indication Action
continue / hold / adjust / stop / restart / review		 Reason & restart-readiness criteria Planned date Dose Responsible prescriber Lab / BP monitoring date Actual action / outcome
ACEi / ARB / ARNI
SGLT2 inhibitor
Diuretic (loop / thiazide)
MRA
Metformin
Insulin / sulfonylurea
NSAID (avoid if able)
Antibiotic / antiviral
Contrast-related plan
Supplements / herbals
No single creatinine number, and no fixed number of days, makes every medicine safe to restart. Restart depends on: the original indication still applying, the acute trigger resolving, kidney function being stable enough, acceptable BP / volume / potassium, and monitoring in place. A small creatinine rise after restarting an ACEi/ARB is often expected, not a new injury; a rise over 30% needs review. "Over-the-counter" does not mean kidney-safe. Do not restart or stop any prescription medicine without the agreed plan.
ACEi = ACE inhibitor · ARB = angiotensin-receptor blocker · MRA = mineralocorticoid-receptor antagonist · SGLT2 = sodium-glucose cotransporter-2 · NSAID = non-steroidal anti-inflammatory drug. Educational use only. renalcarematters.com · Page 4 of 8
Home Monitoring Log
Daily for the first 7 days, then weekly to Day 90 · bring this to every visit
 Page 5 of 8 · renalcarematters.com
Date Weight (kg) Sitting BP Standing BP (if told) Urine amount Swelling Breathless? Vomiting / diarrhea / intake Dizzy / faint Glucose (if relevant) Notes
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Week 2
Week 3
Week 4
Weekly…

⚠ Fluids

Do not restrict or force fluids unless your clinician has given you a specific target. Fluid needs are individual — especially with heart failure, cirrhosis, or on dialysis, where too much fluid is harmful. If your dialysis access shows redness, swelling, or discharge, contact your team.

Educational use only. Ask your clinician which of these to record and how often. Bring this log to each visit. renalcarematters.com · Page 5 of 8
My Sick-Day & Urgent-Action Plan
Completed by my clinician · individualized and time-limited · review date set
 Page 6 of 8 · renalcarematters.com
Symptoms that should trigger contact
Medicines to pause temporarily when acutely ill
clinician-specified only
Maximum time to hold before contacting the team
Medicines that must NOT be stopped without direct instruction
Glucose / insulin instructions (if diabetic)
Fluid advice & heart-failure exception
Who to call
During office hoursAfter office hours / emergency
Date this plan should be reviewedClinician signature

🚑 Seek urgent care now if you have any of these

Much less urine or no urine · new or worsening breathlessness, swelling, or rapid weight gain · unable to keep fluids down, persistent vomiting or diarrhea, or fainting · confusion, severe drowsiness, chest pain, severe weakness, or a racing/irregular heartbeat · fever, chills, or redness/discharge around a dialysis catheter · blood pressure or blood sugar your plan cannot control · any instruction from your team based on a dangerous potassium, bicarbonate, or creatinine result.

Contact your treating team or your local emergency service. Keep this planner and your medication list where a family member can find them.

Sick-day medicine guidance has low-certainty evidence and is easy to get wrong — it must be individualized, time-limited, and paired with a restart plan. Never blanket "stop everything."
Educational use only. This plan is written by your clinician for you specifically and does not apply to anyone else. renalcarematters.com · Page 6 of 8
AKI-D Recovery Addendum
Only if you are still on dialysis after AKI · recovery is assessed, not assumed permanent
 Page 7 of 8 · renalcarematters.com

Status: AKI requiring dialysis — recovery under assessment

Dialysis after AKI is a treatment, not automatically a permanent diagnosis. About half of people who leave the hospital still on dialysis after AKI recover enough to stop, often within 90 days. Ask that your records say "AKI-D — recovery under assessment," not "end-stage kidney disease," while recovery is still possible.

Dialysis unit & nephrologist
Access typeCurrent frequency / duration
Weekly recovery-monitoring (first month) — record the trend
Predialysis SCr / BUN / K / HCO₃ trend
Urine volume (24 h)Timed urine: date · duration · creatinine clearance
Pre / post weight & BP; intradialytic hypotension?Ultrafiltration target & symptoms
Diuretic plan
Recovery-probability discussion dateTrial-off-dialysis assessment date
Long-term access / modality discussion (if needed)
Explicit status
AKI-D — recovery under assessment    Recovery signals present — clinician assessment needed    Preparing long-term KRT (recovery surveillance continues)
No automated "safe to stop dialysis" output exists — and none belongs here. Predictors such as urine output > 450 mL/24 h without diuretics (or > 2,300 mL/24 h with diuretics) and a 2-hour timed creatinine clearance ≥ 23 mL/min may help predict successful discontinuation in adults, but they are predictors, not stop rules. A supervised trial off dialysis is a clinician decision that also weighs fluid balance, acid–base, electrolytes, catabolism, and the ability to rescue if the trial fails. Do not interpret diuretic-driven urine volume as recovered clearance. Confirm current PhilHealth eligibility and documentation with your treating facility.
AKI-D = AKI requiring dialysis · KRT = kidney replacement therapy · BUN = blood urea nitrogen. Educational use only. renalcarematters.com · Page 7 of 8
Day-90 Outcome & Next Plan
One documented outcome · a prior AKI stays a risk marker even if normal
 Page 8 of 8 · renalcarematters.com
Day-90 outcome — tick ONE
Complete resolution by proposed draft criteria — history of AKI remains clinically relevant.
Partial resolution — ongoing monitoring and risk-reduction plan required.
New CKD identified.
Pre-existing CKD worsened after AKI/AKD.
Ongoing kidney failure / KRT — recovery assessment and long-term pathway documented.
Day-90 eGFR & UACR categoryFinal / working diagnosis
Medication & kidney/heart-protection plan
Recurrence-prevention & sick-day plan renewed?Next test & visit date
Nephrology follow-up?Yes   No — why:Long-term surveillance interval
Patient teach-back — I can say in my own words
I know my baseline kidney numbers. I know my warning signs. I know my medication plan and who owns it.
Clinician nameSignatureDate

✅ If no CKD is found

The right wording is "no CKD identified at 90 days" — not "your kidneys are permanently normal." A prior AKI stays a risk marker, so keep a plan for long-term surveillance and for the next time you get sick.

For educational use only. This planner incorporates proposals from the March 2026 KDIGO AKI/AKD public-review draft, which is not final and may change. It does not replace individualized medical advice. References & the full guide: renalcarematters.com/guides/aki-does-not-end-at-discharge.html renalcarematters.com
Page 8 of 8 · renalcarematters.com/guides/aki-does-not-end-at-discharge.html