Applying KDIGO criteria to AKI
There is much debate in my company concerning the application of the "Increase in creatinine >0.3 mg/dl" criteria. KDIGO notes that the 0.3 criterion can only be applied "prospectively" when the baseline has been measured whtin the "preceding 48 hours." Some say this can be applied in the situation where a pt. is admitted with Cr 1.2 which decreases during the stay to 0.9. I argue that the term "prospectively" would apply to an increase after the 1.2 creatinine but would not apply to the 0.3 decrease. If so, why do they specifically say that the x1.5 criterion works both prostpectively AND retrospectively? Please- if someone can provide us with "official" clarification and examples? That would be wonderful. It seems clear to me, but it apparently seems clear to them also.