Review
Clinical review: RIFLE and AKIN – time for reappraisal
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* Corresponding author: Dinna N Cruz dinnacruzmd@yahoo.com
1 Department of Nephrology, Ospedale San Bortolo, Viale Rodolfi 37, 36100 Vicenza, Italy
2 International Renal Research Institute Vicenza, Viale Rodolfi 37, 36100 Vicenza, Italy
3 Department of Pediatric Cardiosurgery, Bambino Gesù Hospital, Piazza San Onofrio 4, 00100 Rome, Italy
Critical Care 2009, 13:211 doi:10.1186/cc7759
Published: 25 June 2009Abstract
In recent years, the use of the consensus definitions of acute kidney injury (RIFLE and AKIN) in the literature has increased substantially. This indicates a highly encouraging acceptance by the medical community of a unifying definition for acute kidney injury. This is a very important and positive step in the right direction. There remains some variation in how the criteria are interpreted and used in the literature, including use/nonuse of urine output criteria, use of change in estimated glomerular filtration rate rather than change in creatinine, and choice of baseline creatinine. The present review is intended to aid the reader in critically appraising studies using these consensus definitions. Since no single definition will be perfect, a logical next step would be to reconcile existing definitions, moving the medical community towards using a single consensus definition as has been done with sepsis and acute lung injury/acute respiratory distress syndrome. As new data emerge, integration of novel biomarkers into the consensus definition will be a welcome refinement.