Copyright
©2014 Baishideng Publishing Group Inc.
World J Hepatol. Oct 27, 2014; 6(10): 696-703
Published online Oct 27, 2014. doi: 10.4254/wjh.v6.i10.696
Published online Oct 27, 2014. doi: 10.4254/wjh.v6.i10.696
Criteria | RIFLE[7] | AKIN[8] | KDIGO[9] |
Date of release | 2004 | 2007 | 2012 |
Time interval | Diagnosis and Staging: Within 1-7 d and sustained more than 24 h | Diagnosis: Within 48 h Staging: 1 wk | Diagnosis: 50% increase within 7 d or ≥ 0.3 mg/dL (26.5 μmol/L) within 48 h |
Stage 1 or R | Increased SCr 1.5-1.9 times baseline | Increased SCr 1.5-1.9 times baseline or ≥ 0.3 mg/dL (≥ 26.5 μmol/L) increase | Increased SCr 1.5-1.9 times baseline (7 d) or ≥ 0.3 mg/dL (≥ 26.5 μmol/L) increase (48 h) |
Stage 2 or I | Increased SCr 2.0-2.9 times baseline | Increased SCr 2.0-2.9 times baseline | Increased SCr 2.0-2.9 times baseline |
Stage 3 or F | Increased SCr 3.0 times baseline, or Increase in SCr ≥ 4.0 mg/dL (350 μmol/L) with an acute rise of ≥ 0.5 mg/dL (44 μmol/L) | Increased SCr 3.0 times baseline, or Increase in SCr ≥ 4.0 mg/dL (350 μmol/L) with an acute rise of ≥ 0.5 mg/dL (44 μmol/L) | Increased SCr 3.0 times baseline, or Increase in SCr ≥ 4.0 mg/dL (350 μmol/L) |
Advantages | Disadvantages | |
Serum marker | ||
Creatinine | Widely available | Influenced by several factors unrelated to renal function, including dehydration and volume expansion, dietary protein, muscle mass, physical activity and thyroid hormones renal tubular secretion affected by chronic kidney disease, proteinuria and drugs not an early biomarker of acute kidney injury Absence of standardization of the laboratory methods for jaundiced patients |
Clearance of exogenous marker | “Gold standard” | technical difficulties and expense make impractical for routine clinical practice stable renal function Less reliable in patients with oedema, ascites, pleural effusions and sarcopenia |
Creatinine Clearance f | ||
(24 h urine collection) | ? more accurate compared to Cr | Inconvenient for outpatientsoverestimates GFR in proteinuria chronic kidney disease influenced by muscle metabolism and diet, inflammatory disease and malnutrition Unexplained variation due to incomplete urine collection and errors in urine volume measurement overestimation of GFR in patients with cirrhosis |
Mathematical formulae based on Cr | Easier method compared to 24 h urine collection | Not validated for patients with changing renal function (acute kidney injury, muscle wasting disorders) Does not overcome the limitations in serum creatinine |
C-G formula | Requires only gender, age, body weight | Difficult to determine body weight in patients with ascites and post LT |
MDRD formula | Body weight is not needed ethnicity, gender and age are taken into account | Has not been validated in patients with chronic liver disease 6-variables formula: needs albumin, urea Only validated in stable chronic kidney disease patients |
- Citation: Agarwal B, Davenport A. Difficulties in diagnosing acute kidney injury post liver transplantation using serum creatinine based diagnostic criteria. World J Hepatol 2014; 6(10): 696-703
- URL: https://www.wjgnet.com/1948-5182/full/v6/i10/696.htm
- DOI: https://dx.doi.org/10.4254/wjh.v6.i10.696