Review Article
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 |
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