Table 1 |
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Classification/staging system for acute kidney injury |
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| System |
Class/stage |
Serum creatinine criteria |
Urine output criteria |
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| RIFLE |
Class R |
Serum creatinine increase to 1.5-fold or GFR decrease >25% from baseline |
<0.5 ml/kg/hour for 6 hours |
| Class I |
Serum creatinine increase to 2-fold or GFR decrease >50% from baseline |
<0.5 ml/kg/hour for 12 hours |
|
| Class F |
Serum creatinine to 3-fold, GFR decrease >75% from baseline or serum creatinine ≥
4 mg/dl (≥ 354 μmol/l) with an acute increase of at least 0.5 mg/dl (44 μmol/l) |
Anuria for 12 hours |
|
| AKIN |
Stage 1 |
Serum creatinine increase ≥ 0.3 mg/dl (≥ 26.4 μmol/l) or increase to 1.5-fold to 2-fold
from baseline |
<0.5 ml/kg per hour for 6 hours |
| Stage 2 |
Serum creatinine increase >2-fold to 3-fold from baseline |
<0.5 ml/kg per hour for 12 hours |
|
| Stage 3 |
Serum creatinine increase >3-fold from baseline or serum creatinine ≥ 4.0 mg/dl (≥
354 μmol/l) with an acute increase of at least 0.5 mg/dl (44 μmol/l) |
<0.3 ml/kg per hour for 24 hours or anuria for 12 hours |
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| Need for RRT |
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Synopsis of RIFLE and AKIN criteria for AKI classification/staging. Small but significant changes can be identified between the two definitions. A time constraint of 48 hours for diagnosis (creatinine or urine output modifications) is required in AKIN criteria. GFR decreases for diagnosis are specified only by RIFLE. In both cases, only one criterion – creatinine or urine output – must be fulfilled to qualify for a class/stage. Classes L (loss of function) and E (end-stage kidney disease) of the RIFLE criteria are not reported. Given the wide variation in indications and timing of initiation of RRT, individuals who receive RRT are considered to have met the criteria for AKIN stage 3 irrespective of the stage they are in at the time of RRT. From Bellomo and coworkers [4] and Mehta and colleagues [5]. AKI, acute kidney injury; AKIN, Acute Kidney Injury Network; GFR, glomerular filtration rate; RIFLE, Risk, Injury, Failure, Loss and End-stage kidney disease; RRT, renal replacement therapy. |
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Ricci and Ronco Critical Care 2008 12:230 doi:10.1186/cc6952 |
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