RE: [EXTERNAL] Renal failure/renal insuff
International Kidney Disease: Improving Global Outcomes (KDIGO) staging system for Acute Kidney Injury(AKI)
NOTE: Patients should be staged according to whichever criteria (serum creatinine or urine output gives them the highest stage and only after they have been identified as meeting the criteria for the definition of AKI
Stage
Serum Creatinine (SCr) Criteria
Urine Output Criteria
1
Increase SCr ≥ 26 µmol/L within 48 hours or
Increase ≥ 1.5 to 1.9 times reference SCr
< 0.5ml/kg/h for 6
consecutive hours
2
Increase ≥ 2 to 2.9 times reference SCr
< 0.5ml/kg/h for > 12 hours
3
Increase ≥ 3 times reference SCr or
Increase 354 µmol/L or
Commenced on renal replacement therapy (RRT) irrespective of stage
< 0.3 ml/kg/h for 24 hours
or
Anuria for 12 hours
This table on the staging of acute kidney injury may help. Anything less than this would be insufficiency. Also if it is acute kidney injury it should take longer than 8 hours of IV fluid resuscitation for the patients lab values to return to baseline. I normally look and if it takes more than 24 hours I will query for acute kidney injury if they haven’t returned to baseline.
Hope this helps clarify things.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS, VHA-CM
Clinical Documentation Improvement Specialist
Secretary, Nursing Professional Standards Board
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence (“I CARE”)
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative, Agile, Integrated
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens
NOTE: Patients should be staged according to whichever criteria (serum creatinine or urine output gives them the highest stage and only after they have been identified as meeting the criteria for the definition of AKI
Stage
Serum Creatinine (SCr) Criteria
Urine Output Criteria
1
Increase SCr ≥ 26 µmol/L within 48 hours or
Increase ≥ 1.5 to 1.9 times reference SCr
< 0.5ml/kg/h for 6
consecutive hours
2
Increase ≥ 2 to 2.9 times reference SCr
< 0.5ml/kg/h for > 12 hours
3
Increase ≥ 3 times reference SCr or
Increase 354 µmol/L or
Commenced on renal replacement therapy (RRT) irrespective of stage
< 0.3 ml/kg/h for 24 hours
or
Anuria for 12 hours
This table on the staging of acute kidney injury may help. Anything less than this would be insufficiency. Also if it is acute kidney injury it should take longer than 8 hours of IV fluid resuscitation for the patients lab values to return to baseline. I normally look and if it takes more than 24 hours I will query for acute kidney injury if they haven’t returned to baseline.
Hope this helps clarify things.
Robert
Robert S. Hodges MSN, BSN, RN, CCDS, VHA-CM
Clinical Documentation Improvement Specialist
Secretary, Nursing Professional Standards Board
Aleda E. Lutz VA Medical Center
1500 Weiss Street, ATTN PAS-136
Saginaw MI 48602
989-497-2500 x13101
Robert.Hodges2@va.gov
VA Core Values: Integrity, Commitment, Advocacy, Respect, Excellence (“I CARE”)
VA Core Characteristics: Trustworthy, Accessible, Quality, Innovative, Agile, Integrated
"The difference between the right word and the almost right word is the difference between lightning and the lightning bug." Samuel "Mark Twain" Clemens