Acute renal failure classification: Difference between revisions
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===According to the RIFLE criteria=== | ===According to the RIFLE criteria=== | ||
The RIFLE (Risk of renal dysfunction, Injury to the kidney, Failure or Loss of kidney function, and End-stage kidney disease) criteria classifies acute renal failure according to the probable clinical outcomes<ref name="pmid15312219">{{cite journal |author=Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P |title=Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group |journal=[[Critical Care (London, England)]] |volume=8 |issue=4 |pages=R204–12 |year=2004 |month=August |pmid=15312219 |pmc=522841 |doi=10.1186/cc2872 |url=}}</ref>. This system is increasingly used for evaluation of patients with acute kidney injury. | The RIFLE (Risk of renal dysfunction, Injury to the kidney, Failure or Loss of kidney function, and End-stage kidney disease) criteria classifies acute renal failure according to the probable clinical outcomes<ref name="pmid15312219">{{cite journal |author=Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P |title=Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group |journal=[[Critical Care (London, England)]] |volume=8 |issue=4 |pages=R204–12 |year=2004 |month=August |pmid=15312219 |pmc=522841 |doi=10.1186/cc2872 |url=}}</ref><ref>{{cite journal |author=Lameire N, Van Biesen W, Vanholder R |title=Acute renal failure |journal=[[The Lancet|Lancet]] |volume=365 |issue=9457 |pages=417–30 |year=2005 |pmid=15680458 |doi=10.1016/S0140-6736(05)17831-3}}</ref>. This system is increasingly used for evaluation of patients with acute kidney injury. | ||
* Risk: [[GFR]] decrease >25%, serum [[creatinine]] increased 1.5 times or urine production of <0.5 ml/kg/hr for 6 hours | |||
* Injury: [[GFR]] decrease >50%, doubling of [[creatinine]] or urine production <0.5 ml/kg/hr for 12 hours | |||
* Failure: [[GFR]] decrease >75%, tripling of [[creatinine]] or [[creatinine]] >355 μmol/l (with a rise of >44) (>4 mg/dl) OR urine output below 0.3 ml/kg/hr for 24 hours | |||
* Loss: persistent AKI or complete loss of [[renal function|kidney function]] for more than 4 weeks | |||
* [[End-stage renal disease]]: need for renal replacement therapy (RRT) for more than 3 months | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
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{{WS}} | {{WS}} | ||
[[Category:Medical emergencies]] | [[Category:Medical emergencies]] | ||
[[Category:Nephrology]] | [[Category:Nephrology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Intensive care medicine]] | [[Category:Intensive care medicine]] | ||
Revision as of 00:51, 13 January 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
Acute renal failure can complicate a wide spectrum of disorders, and for the purpose of diagnosis and management is divided according to the mechanism that lead to renal compromise. The three categories are pre-renal azotemia (diseases that cause renal hypoperfusion), renal azotemia (diseases directly affecting the renal parenchyma), and post-renal azotemia (diseases affecting the urinary tract causing obstruction).
Classification
According to the levels of renal dysfunction
Acute renal failure is usually categorised (as in the flowchart below) according to pre-renal, renal and post-renal causes.
| Acute Renal Failure | |||||||||||||||||||||||||||||||||
| Pre-renal | Renal | Post-renal | |||||||||||||||||||||||||||||||
1. Pre-renal
- Compromise in the renal blood flow
2. Renal
- Damage to the kidney itself
3. Post-renal
- Obstructive causes in the urinary tract
According to the RIFLE criteria
The RIFLE (Risk of renal dysfunction, Injury to the kidney, Failure or Loss of kidney function, and End-stage kidney disease) criteria classifies acute renal failure according to the probable clinical outcomes[1][2]. This system is increasingly used for evaluation of patients with acute kidney injury.
- Risk: GFR decrease >25%, serum creatinine increased 1.5 times or urine production of <0.5 ml/kg/hr for 6 hours
- Injury: GFR decrease >50%, doubling of creatinine or urine production <0.5 ml/kg/hr for 12 hours
- Failure: GFR decrease >75%, tripling of creatinine or creatinine >355 μmol/l (with a rise of >44) (>4 mg/dl) OR urine output below 0.3 ml/kg/hr for 24 hours
- Loss: persistent AKI or complete loss of kidney function for more than 4 weeks
- End-stage renal disease: need for renal replacement therapy (RRT) for more than 3 months
References
- ↑ Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P (2004). "Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group". Critical Care (London, England). 8 (4): R204–12. doi:10.1186/cc2872. PMC 522841. PMID 15312219. Unknown parameter
|month=ignored (help) - ↑ Lameire N, Van Biesen W, Vanholder R (2005). "Acute renal failure". Lancet. 365 (9457): 417–30. doi:10.1016/S0140-6736(05)17831-3. PMID 15680458.