Measuring acute kidney injury around the world: are we using the right thermometer (and adequately)?

Excerpt

Acute kidney injury (AKI) is bad news in critically ill patients: it is associated with adverse short-term and long-term outcome and with important use of health care resources. Data on the incidence and outcome of AKI are essential to inform clinicians, scientists, and politicians. For decades epidemiological studies have been hampered by the absence of a consensus definition. During the last decade, three definitions of AKI have been developed: the RIFLE definition (Acute Dialysis Quality Initiative), the AKIN definition (Acute Kidney Injury Network), and finally the KDIGO definition (Kidney Disease Improving Global Outcomes) that reconciled the first two. These “modern” definitions and the associated staging criteria are based on increases of serum creatinine, decreases of urine output (UO), and need for renal replacement therapy (RRT) [1]. …