Table 1

Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) classification

Class
GFR criteria
UO criteria

Risk
Serum creatinine × 1.5
<0.5 ml/kg/h × 6 h
Injury
Serum creatinine × 2
<0.5 ml/kg/h × 12 h
Failure
Serum creatinine × 3 or serum creatinine ≥ 4 mg/dl with an acute rise >0.5 mg/dl
<0.3 ml/kg/h × 24 h or anuria × 12 h
Loss
Persistent acute renal failure = complete loss of kidney function >4 weeks

End-stage kidney disease
End-stage kidney disease >3 months


For conversion of creatinine expressed in conventional units to ST units, multiply by 88.4. Patients are categorized on serum creatinine or urinary output (UO), or both, and the criteria that led to the worst classification are used. Glomerular filtration rate (GFR) criteria are calculated as an increase of serum creatinine above the baseline serum creatinine level. When the baseline serum creatinine is unknown and there is no past history of chronic kidney disease, serum creatinine is calculated using the Modification of Diet in Renal Disease formula for assessment of kidney function, assuming a glomerular filtration rate of 75 ml/minute/1.73 m2. Acute kidney injury should be considered when kidney dysfunction is abrupt (within 1 to 7 days) and sustained (more than 24 hours).

Lopes et al. Critical Care 2006 11:401   doi:10.1186/cc5121