Criteria

Kidney Disease: Improving Global Outcomes (KDIGO) - definition criteria[1]

Any of the following:

  • Increase in serum creatinine by ≥26 micromol/L (≥0.3 mg/dL) within 48 hours; or

  • Increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or

  • Urine volume <0.5 mL/kg/hour for 6 hours.

Kidney Disease: Improving Global Outcomes (KDIGO) - severity criteria[1]

  • Stage 1

    • Serum creatinine 1.5 to 1.9 times baseline; or

    • ≥26 micromol/L (≥0.3 mg/dL) increase in serum creatinine; or

    • Urine output <0.5 mL/kg/hour body weight for 6 to 12 hours

  • Stage 2

    • Creatinine increased 2.0 to 2.9 times; or

    • Urine output <0.5 mL/kg/hour for 12 hours or longer

  • Stage 3

    • Creatinine increased ≥3.0 times; or

    • Increase in creatinine to ≥354 micromol/L (≥4.0 mg/dL); or

    • Initiation of renal replacement therapy; or

    • Urine output <0.3 mL/kg/hour for 24 hours OR anuria for 12 hours.

RIFLE (Risk, Injury, Failure, Loss of kidney function, and Endstage kidney disease) consensus criteria[69]

Laboratory test indicates reduced kidney clearance.

Severity groups are as follows.

  • Indicates risk:

    • Serum creatinine increased 1.5 times; or

    • Urine production of <0.5 mL/kg body weight for 6 hours.

  • Indicates injury:

    • Creatinine increased 2.0 times; or

    • Urine production of <0.5 mL/kg for 12 hours.

  • Indicates failure:

    • Creatinine increased 3.0 times; or

    • Urine output <0.3 mL/kg for 24 hours or anuria for 12 hours.

  • Indicates loss:

    • Persistent AKI for more than 4 weeks; complete loss of kidney function.

  • Indicates ESRD:

    • ESRD (loss >3 months).

National Institute for Health and Care Excellence: detecting acute kidney injury[3]

Detect AKI, in line with the RIFLE, Acute Kidney Injury Network (AKIN), or KDIGO definitions, by using any of the following criteria:

  • A rise in serum creatinine of 26 micromol/L (0.3 mg/dL) or greater within 48 hours; or

  • A 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days; or

  • A fall in urine output to <0.5 mL/kg/hour for more than 6 hours in adults and more than 8 hours in children and young people; or

  • A 25% or greater fall in estimated GFR in children and young people within the past 7 days.

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