Classification and staging of acute kidney injury: Beyond the RIFLE and AKIN criteria

Zaccaria Ricci, Dinna N. Cruz, Claudio Ronco

Research output: Contribution to journalArticle

Abstract

Acute kidney injury (AKI) is often overlooked in hospitalized patients, despite the fact that even mild forms are strongly associated with poor clinical outcomes such as increased mortality, morbidity, cardiovascular failure and infections. Research endorsed by the Acute Dialysis Quality Initiative led to the publication of a consensus definition for AKIg-the RIFLE criteria (Risk, Injury, Failure, Loss of function, and End-stage renal disease)g-which was designed to standardize and classify renal dysfunction. These criteria, along with revised versions developed by the AKI Network (AKIN), can detect AKI with high sensitivity and high specificity and describe different severity levels that aim to predict the prognosis of affected patients. The RIFLE and AKIN criteria are easy to use in a variety of clinical and research settings, but have several limitations: both utilize an increase in serum creatinine level from a hypothetical baseline value and a decrease in urine output, but these surrogate markers of renal impairment manifest relatively late after injury has occurred and do not consider the nature or site of the kidney injury. New biomarkers for AKI have shown promise for early diagnosis and prediction of the prognosis of AKI. As more data become available, they could, in the future, be incorporated into improved definitions or criteria for AKI.

Original languageEnglish
Pages (from-to)201-208
Number of pages8
JournalNature Reviews Nephrology
Volume7
Issue number4
DOIs
Publication statusPublished - Apr 2011

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Acute Kidney Injury
Kidney
Wounds and Injuries
Cardiovascular Infections
Biomarkers
Research
Chronic Kidney Failure
Publications
Early Diagnosis
Dialysis
Creatinine
Urine
Morbidity
Sensitivity and Specificity
Mortality
Serum

ASJC Scopus subject areas

  • Nephrology

Cite this

Classification and staging of acute kidney injury : Beyond the RIFLE and AKIN criteria. / Ricci, Zaccaria; Cruz, Dinna N.; Ronco, Claudio.

In: Nature Reviews Nephrology, Vol. 7, No. 4, 04.2011, p. 201-208.

Research output: Contribution to journalArticle

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