How is the degree of acute kidney injury (AKI) determined in acute tubular necrosis (ATN)?

Updated: Mar 15, 2021
  • Author: Sangeeta Mutnuri, MBBS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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The degree of acute kidney injury (AKI) is determined using the RIFLE (Risk of renal dysfunction, Injury to the kidney, Failure or Loss of kidney function, and End-stage renal disease) criteria. [15]

The primary goal of the Acute Dialysis Quality Initiative (ADQI), created in 2002, was to develop consensus- and evidence-based guidelines that could be used to treat and prevent AKI. A uniform, accepted definition of AKI was developed, and, as a result, the RIFLE criteria were proposed. The RIFLE criteria comprise a classification system for AKI. [15]

Since their creation in 2002, the RIFLE criteria have been validated by different groups around the world. The AKIN report proposed modifications to the RIFLE criteria to take into account evidence that smaller changes in serum creatinine than those first proposed in RIFLE are indicative of adverse outcomes. The AKIN staging system therefore requires only one measure (serum creatinine or urine output) to be satisfied to meet stage criteria. [16]

For more information on RIFLE and AKIN, see Classification Systems for Acute Kidney Injury.

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