Query For AKI

littlebit_62703@yahoo.comlittlebit_62703@yahoo.com
in Clinical & Coding

I have been going back and forth on this and have read a lot of posting on this subject and wanted to know thoughts.

Patient dx with Acute renal insufficiency 

11/30 Creatinine 0.96, 12/2 Creatinine 1.32, on discharge -1.09.　 IVF, increase po intake.　 Monitor

 Would you query for AKI?

Comments

  • crabwelsh@gmail.comcrabwelsh@gmail.com
    Since AKI codes to acute renal failure, at our facilities we use the same criteria and only query if it meets our definition of Acute renal failure. 
  • evanspx@sutterhealth.orgevanspx@sutterhealth.org

    AKI is an abbreviation and may mean 'insufficiency', rather than injury. 



  • proddy@clarionhospital.orgproddy@clarionhospital.org
    I think it depends on if your hospital has some established diagnosis guidelines for your facility or what you follow?  At my hospital, since the creatinine on admission is > or equal 1.3 times the lab value on 11/30 (3 days earlier) , I would probably query for it
  • afrady@blr.comafrady@blr.com
    Acute Kidney Injury (non traumatic) is an inclusion term in the ICD 10 tabular now for N17.9  I believe it was also addressed as being N17.9 in coding clinic.

    You do appear to have KDIGO criteria as a prospective measurement for hospital acquired simple AKI as evidence by an onset rise in the measured increased in Scr of greater than or equal to 0.3mg/dl within a 48 hour period. 

    What was the cause of the dehydration?  Aggressive tx with diuretics?

    Acute renal insufficiency = N28.9
    Acute Kidney Injury/failure = N17.9
  • morris-jeff@CooperHealth.edumorris-jeff@CooperHealth.edu

    Littlebit

    I am going to paste the link to the KDIGO document. It's very long but basically you just need to look at the tables and diagnostic criteria. There are also a few other "nuggets" in there like what SCr to use as baseline in a certain aged patient without mention of renal disease. Basically KDIGO defines AKI as any of the following: Increase in serum creatinine by 0.3mg/dL or more within 48 hours or. Increase in serum creatinine to 1.5 times baseline or more within the last 7 days or. Urine output less than 0.5 mL/kg/h for 6 hours.

    https://www.kdigo.org/clinical_practice_guidelines/pdf/KDIGO AKI Guideline.pdf

    Jeff

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