How does ACKF differ from AKI?

ACKF occurs on a background of CKD. Baseline creatinine is already elevated; incremental rises define staging. ACKF has worse outcomes: higher RRT requirement (25% vs 5%) and lower recovery rates.

ACKF causes: volume depletion (most common), infection/sepsis, drug toxicity (NSAIDs, RAAS blockade), contrast nephropathy, urinary obstruction, and cardiac decompensation.

Can RAAS blockade be continued during ACKF?

RAAS blockade should generally be held during ACKF while volume status is corrected and the cause is treated. Restart when serum creatinine stabilizes or returns toward baseline.

Acute-on-Chronic Kidney Failure Staging

Stage acute-on-chronic kidney failure (ACKF) using ADQI 2021 consensus: Stage 1 (creatinine rise 1.5-1.9x baseline), Stage 2 (2-2.9x), Stage 3 (>=3x or new RRT) in CKD patients.

Use the full interactive calculator below, or

Related Calculators

AKI to CKD Transition Risk

Hyper-niche Medical

Renal Recovery 90-Day

Hyper-niche Medical

Acute-on-Chronic Kidney Failure Staging

Related Calculators

Frequently Asked Questions

How does ACKF differ from AKI?

What causes ACKF?

Can RAAS blockade be continued during ACKF?