Acute Kidney Injury

Question 1

What is the Kidney Disease: Improving Global Outcomes (KDIGO) classification of AKI

Answer 1

Stage 1

• Creat increased 1.5 to 2 x baseline OR
• Urine output < 0.5 ml/kg/hr for 6 - 12 hrs

Stage 2

• Creat increased 2 - 3 x baseline OR
• Urine output < 0.5 ml/kg/hr for > 12 hrs

Stage 3

• Creat increased > 3 x baseline OR
• Creat increased to > 353 umol/L
• Urine output < 0.3 ml/kg/hr > 24 hrs OR
• Anuria > 12 hrs
• Inititation of RRT
• eGFR (kids < 18 yrs) less than 35 ml/min/1.73m2

Question 2

What are the indications for acute renal replacement therapy

Answer 2

A - Acidosis - severe metabolic acidosis (pH < 7.1)
E - Electrolytes - hyperkalaemia > 6.5mmol/L
I - Intoxication - toxic OD dialyzable drug
O - Overload - fluid overload refractory to diuretics
U - Uremia

Also consider patients with expected deterioration despite maximal other supportive and medical therapy without above triggers.