What are KDIGO AKI stages?

Stage 1: SCr ×1.5-1.9x baseline or +0.3 mg/dL or UO <0.5 mL/kg/h for 6-12h; Stage 2: SCr ×2.0-2.9x baseline or UO <0.5 mL/kg/h ≥12h; Stage 3: SCr ×3x baseline or SCr ≥4 mg/dL or dialysis or UO <0.3 mL/kg/h ≥24h.

What are the emergency indications for RRT initiation?

Absolute emergent indications (AEIOU): A=Acidosis (pH 6.5 unresponsive to treatment); I=Ingestion (dialyzable toxin: lithium, methanol, salicylate); O=Overload (pulmonary edema refractory to diuretics); U=Uremia (uremic pericarditis, encephalopathy).

Does early vs late RRT initiation affect outcomes?

STARRT-AKI (2020) and AKIKI (2016) trials found no mortality benefit from early vs standard RRT initiation; standard initiation (waiting for AKI stage 3 with AEIOU) is acceptable; early initiation does not improve survival and exposes patients to RRT risks.

What CRRT dose is recommended in AKI?

KDIGO recommends effluent volume of 20-25 mL/kg/h for CRRT (CVVH, CVVHD, or CVVHDF); higher doses (35-40 mL/kg/h) did not improve outcomes in RENAL and ATN trials; prescription dose should be 20-25% above target to account for interruptions.

What biomarkers predict AKI before creatinine rise?

NGAL (neutrophil gelatinase-associated lipocalin), KIM-1, IL-18, and urinary L-FABP rise 2-6 hours before creatinine; TIMP-2 and IGFBP7 (NephroCheck) predict AKI within 12 hours; FDA-cleared for high-risk AKI assessment post-cardiac surgery.

AKI KDIGO Staging and Renal Replacement Therapy Threshold

Stages acute kidney injury per KDIGO 2012 criteria using serum creatinine rise and urine output, calculates RRT initiation thresholds (STARRT-AKI, AKIKI criteria), and estimates creatinine kinetics.

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Frequently Asked Questions

What are KDIGO AKI stages?

What are the emergency indications for RRT initiation?

Does early vs late RRT initiation affect outcomes?

What CRRT dose is recommended in AKI?

What biomarkers predict AKI before creatinine rise?