Volume Management in the Critically Ill Patient with Acute Kidney Injury

Table 1

Comparison of RIFLE and AKIN criteria for the acute kidney injury (AKI).

RIFLE category	Serum creatinine criteria	Urine output criteria
The Acute Dialysis Quality Initiative (ADQI) criteria for the definition and classification of AKI (i.e., RIFLE criteria)
Risk	Increase in serum creatinine ≥1.5 X baseline or decrease in GFR ≥25%	<0.5 mL/kg/h for ≥6 h
Injury	Increase in serum creatinine ≥2.0 X baseline or decrease in GFR ≥50%	<0.5 mL/kg/h for ≥12 h
Failure	Increase in serum creatinine ≥3.0 X baseline or decrease in GFR ≥75% or an	<0.3 mL/kg/h ≥24 h or
	absolute serum creatinine ≥4.0 mg/dL with an acute rise of at least 0.5 mg dL	anuria ≥12 h
Loss	Persistent acute renal failure—complete loss of kidney function ≥4 weeks	N/A
EskD	End-stage kidney disease ≥3 months	N/A
AKIN stages	Serum creatinine criteria	Urine output criteria
The proposed Acute Kidney Injury Network (AKIN) criteria for the definition and classification of AKI
Stage 1	Increase in serum creatinine ≥0.3 mg/dL or increase to ≥150–199% (1.5- to 1.9-fold) from baseline	<0.5 mL/kg/h for ≥6 h
Stage 2	Increase in serum creatinine to 200–299% (>2–2.9-fold) from baseline	<0.5 mL/kg/h for ≥12 h
Stage 3	Increase in serum creatinine to ≥300% (≥3-fold) from baseline or serum creatinine	<0.3 mL/kg/h ≥24 h or
	≥4.0 mg/dL with an acute rise of at least 0.5 mg/dL or initiation of RRT	anuria ≥12 h