Page 138 - Critical Care Notes

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GU

Causes of AKI
Prerenal Intrarenal Postrenal

Renal perfusion Parenchymal damage Obstruction
Nephron destruction
Decreased glomerular filtration

Acute kidney injury

Risk Injury Failure Loss End-Stage (RIFLE)
Classification System for AKI Consists of Three
Stages and Two Outcome Measures
GFR or Serum
Stage Creatinine Criteria Urine Output Criteria
Risk GFR decrease >25% baseline or Urine output <0.5 mL/kg/hr
Stage 1 Serum creatinine increased for 6 hr
× 1.5 baseline
Injury GFR decrease >50% baseline or Urine output <0.5 mL/kg/hr
Stage 2 Serum creatinine increased for 12 hr
× 2 baseline
Failure GFR decrease >75% baseline or Urine output <0.3 mL/kg/hr
Stage 3 Serum creatinine increased × 3 for 24 hr or anuria for
baseline or creatinine >4 mg/dL; 12 hr
acute rise >0.5 mg/dL
Loss Complete loss of renal function
>4 wk
End-stage Complete loss of renal function
kidney >3 mo
disease
(ESKD)
Patients can be classified by GFR criteria or urine output criteria, but criteria that support the
most severe classification should be used.
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