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Box 25.1

Acute Kidney Injury (AKI)

AKI is defined by:

  • A rise in serum creatinine by ≥27μmol/L, in 48h or less
  • A >50% rise in serum creatinine from baseline, in 7 days, or
  • A urine output of <0.5 mL/kg/h for >6h.

AKI is staged by the magnitude of the rise in serum creatinine or decrease in urine output:

Stage of AKISerum creatinineUrine output
1Rise in serum creatinine ≥27μmol/L in 48h, or rise 1.5–1.9 times from baseline<0.5 mL/kg/h for 6–12h
2Rise in serum creatinine 2.0–2.9 times from baseline<0.5 mL/kg/h for ≥12h
3Rise in serum creatinine three times from baseline, or increase in serum creatinine to ≥354μmol/L, or initiation of renal replacement therapy irrespective of serum creatinine<0.3 mL/kg/h for ≥24h or anuria for ≥12h