Vol. 2, Issue 1, Part A (2025)

Acute Kidney Injury (AKI) represents a significant burden on global healthcare systems due to its rising incidence, associated morbidity, mortality, and long-term complications. Traditionally managed by physicians, AKI treatment protocols have undergone recent paradigm shifts with the integration of nurse-driven approaches in both critical care and general ward settings. This paper undertakes a comprehensive comparative study to evaluate the efficacy, timeliness, patient outcomes, and resource optimization between nurse-driven protocols and conventional physician-led strategies in AKI management. Emphasis is placed on the initiation of renal replacement therapy (RRT), fluid resuscitation, electrolyte balance, early detection through biomarkers, and adherence to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.

A narrative methodology is employed, reviewing evidence from multicenter clinical trials, cohort studies, and qualitative analyses, with a focus on high-income and low-resource settings alike. The study also explores how interdisciplinary collaboration influences patient prognosis and the potential barriers nurses face in protocol implementation, including institutional support, training, and autonomy. Results indicate that while physician-led protocols offer comprehensive diagnostic oversight, nurse-driven models significantly reduce intervention time, improve adherence to monitoring schedules, and enhance patient engagement.

Findings support the conclusion that a hybrid model, where nurse-led interventions are embedded within a physician-supervised framework, may offer the best clinical outcomes in AKI care. The paper recommends that health systems invest in structured training programs, digital monitoring tools, and policy frameworks that empower nurses while retaining diagnostic authority with physicians. This shift could lead to more agile, cost-effective, and patient-centered AKI management globally.