Current diagnostic criteria for acute kidney injury (AKI) in the general population and in patients with cirrhosis
| RIFLE criteria | AKIN criteria | KDIGO criteria | Conventional criteria for diagnosis of AKI in cirrhosis | |
|---|---|---|---|---|
| Diagnostic criteria | Increase in SCr to ≥1.5 times baseline, within 7 days; or GFR decrease >25%; or Urine volume <0.5 mL/kg/h for 6 h | Increase in sCr by ≥0.3 mg/dL (26.5 µmol/L) within 48 h; or Increase in sCr ≥1.5 times baseline within 48 h; orUrine volume <0.5 mL/kg/h for 6 h | Increase in sCr by ≥0.3 mg/dL (26.5 µmol/L) within 48 h; or Increase in SCr to ≥1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or Urine volume <0.5 mL/kg/h for 6 h | A percentage increase in sCr of ≥50% to a final value of sCr >1.5 mg/dL (133 µmol/L) |
| Staging | Risk: sCr increase 1.5–1.9 times baseline; or GFR decrease 25–50%; orUrine output <0.5 mL/kg/h for 6 h | Stage 1: sCr increase 1.5–1.9 times baseline; or sCr increase ≥0.3 mg/dL (26.5 µmol/L); or Urine output <0.5 mL/kg/h for 6 h | Stage 1: sCr increase 1.5–1.9 times baseline; or sCr increase ≥0.3 mg/dL (26.5 µmol/L); or Urine output <0.5 mL/kg/h for 6–12 h | Not provided |
| Injury: sCr increase 2.0–2.9 times baseline; or GFR decrease 50–75%; or Urine output <0.5 mL/kg/h for 12 h | Stage 2: sCr increase 2.0–2.9 times baseline; or Urine output <0.5 mL/kg/h for 12 h | Stage 2: sCr increase 2.0–2.9 times baseline; or Urine output <0.5 mL/kg/h for ≥ 12 h | ||
| Failure: sCr increase ≥3.0 times baseline: or GFR decrease 50–75%; or sCr increase ≥4.0 mg/dL (353.6 µmol/L) with an acute increase of at least 0.5 mg/dL (44 µmol/L); orUrine output <0.3 mL/kg/h for ≥24 h; or Anuria for ≥12 h | Stage 3: sCr increase 3.0 times baseline; or sCr increase ≥4.0 mg/dL (353.6 µmol/L) with an acute increase of at least 0.5 mg/dL (44 µmol/L); orUrine output <0.3 mL/kg/h for ≥24 h; or Anuria for ≥12 h | Stage 3: sCr increase 3.0 times baseline; or sCr increase to ≥4.0 mg/dL (353.6 µmol/L); or Initiation of renal replacement therapy; orUrine output <0.3 mL/kg/h for ≥24 h; or Anuria for ≥12 h |
AKIN, Acute Kidney Injury Network; GFR, glomerular filtration rate; KDIGO, Kidney Disease Improving Global Outcome; RIFLE, Risk, Injury, Failure, Loss, End stage renal disease; sCr, serum creatinine.