Acute kidney injury definitions and staging
| Criteria . | Risk, Injury, Failure, Loss, End-Stage (RIFLE)96 . | Pediatric Risk, Injury, Failure, Loss, End-Stage (pRIFLE)97 . | Acute Kidney Injury Network (AKIN)98 . | |||
|---|---|---|---|---|---|---|
| Creatinine . | Urine . | Creatinine . | Urine . | Creatinine . | Urine . | |
| Risk | 1.5 × ↑ creat or > 25% ↓ GFR* | < 0.5 mL/kg/h × 6 h | 25% ↓ GFR† | < 0.5 mL/kg/h ×8 h | ||
| Injury | 2 × ↑ creat or > 50% ↓ GFR* | < 0.5 mL/kg/h × 12 h | 50% ↓ GFR† | < 0.5 mL/kg/h × 16 h | 1.5 × or ≥ 0.3 mg/dL ↑ creat | < 0.5 mL/kg/h × 6 h |
| Failure | 3 × ↑creat, > 75% ↓ GFR,* or creat > 4 mg/dL | < 0.3 mL/kg/h × 24 h or anuria × 12 h | > 75% ↓ GFR† or GFR† < 35 | < 0.3 mL/kg/h × 24 h or anuria × 12 h | ||
| Loss | Dialysis > 4 wk | Dialysis > 4 wk | ||||
| ESRD | Dialysis > 3 mo | Dialysis > 3 mo | ||||
| Criteria . | Risk, Injury, Failure, Loss, End-Stage (RIFLE)96 . | Pediatric Risk, Injury, Failure, Loss, End-Stage (pRIFLE)97 . | Acute Kidney Injury Network (AKIN)98 . | |||
|---|---|---|---|---|---|---|
| Creatinine . | Urine . | Creatinine . | Urine . | Creatinine . | Urine . | |
| Risk | 1.5 × ↑ creat or > 25% ↓ GFR* | < 0.5 mL/kg/h × 6 h | 25% ↓ GFR† | < 0.5 mL/kg/h ×8 h | ||
| Injury | 2 × ↑ creat or > 50% ↓ GFR* | < 0.5 mL/kg/h × 12 h | 50% ↓ GFR† | < 0.5 mL/kg/h × 16 h | 1.5 × or ≥ 0.3 mg/dL ↑ creat | < 0.5 mL/kg/h × 6 h |
| Failure | 3 × ↑creat, > 75% ↓ GFR,* or creat > 4 mg/dL | < 0.3 mL/kg/h × 24 h or anuria × 12 h | > 75% ↓ GFR† or GFR† < 35 | < 0.3 mL/kg/h × 24 h or anuria × 12 h | ||
| Loss | Dialysis > 4 wk | Dialysis > 4 wk | ||||
| ESRD | Dialysis > 3 mo | Dialysis > 3 mo | ||||
Creat indicates serum creatinine; GFR, glomerular filtration rate (mL/min/1.73 m2); ↑, increased; ↓, decreased; and ESRD, end-stage renal disease.
Based on the Modification of Diet in Renal Disease (MDRD) formula as follows: GFR = [186 × Creat−1.154 × age−0.203 × 0.742 if female × 1.210 if African American].99
Based on the original Schwarz formula as follows: GFR = [k × height in cm/Creat]; where k = 0.33 in premature infants, 0.45 in term infants to 1 year of age, 0.55 in children to 13 years of age, and 0.70 in adolescent males 13-21 years of age. The most recent Schwarz formula uses a k = 0.413 in all children.100