Renal Failure

Acute Kidney Injury (AKI)

Definition (KDIGO 2012;2:1)

  • Stages in ICU correspond to ↑ hospital mortality and LOS (Crit Care Med 2009;37:2552)
    • Stage 1: Cr ≥0.3 mg/dL in 2d or ↑ Cr ≥50%, or UOP <0.5 mL/kg/h for ≥6h
    • Stage 2: ↑ Cr 2–3x baseline in 7d or UOP <0.5 mL/kg/h for ≥12h
    • Stage 3: ↑ 3x baseline in 7d, UOP <0.3 mL/kg/h for ≥24h, anuria ≥ 12h, or Cr >4
  • Cannot estimate GFR using Cr in setting of AKI or ∆’ing Cr (requires steady state)

Workup (NEJM 2014;371:55)