BUMC Basics.pdf - Anesthesia Home

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ACUTE KIDNEY INJURY
Acute Kidney Injury Network (AKIN) definition of
AKI: (Have offered a modification/update of RIFLE)
The proposed diagnostic criteria are an abrupt (within 48
hours):
• Absolute increase in the serum creatinine concentration
of ≥0.3 mg/dL from baseline, or
• A percentage increase in the serum creatinine
concentration of ≥50 percent,
• Or oliguria of less than 0.5 mL/kg per hour for more than
six hours.
The diagnostic criteria should be applied only after volume
status has been optimized and urinary tract obstruction has
been ruled out if oliguria was used as the sole diagnostic
criterion.
The Acute Kidney Injury Network also includes a staging
system that correlates to the RIFLE criteria. Stage 1 (risk),
stage 2 (injury), and stage 3 (failure) are included and loss and
ESRD are considered outcomes.
RIFLE criteria proposed by the Acute Dialysis
Quality Initiative (ADQI):
• Risk — 1.5-fold increase in the serum creatinine or GFR
decrease by 25 percent or urine output