Acute kidney injury spectrum in patients with chronic liver disease: Where do we stand?

Table 3 The proposed classification system of renal dysfunction in patients with cirrhosis proposed by the Acute Dialysis Quality Initiative and the International Club of Ascites work group[12]

Diagnosis	Definition
Acute kidney injury (AKI)	Rise in serum creatinine (SCr) of ≥ 50% from baseline or a rise in SCr by ≥ 0.3 mg/dL (26.5 μmol/L) in < 48 h. Hepatorenal syndrome (HRS) type 1 is a specific form of AKI
	Stage 1: Increase in serum creatinine (SCr) ≥ 0.3 mg/dL (26.5 μmol/L) or an increase in SCr 1.5-fold to 2-fold from baseline
	Stage 2: Increase in SCr > 2-fold to 3-fold from baseline
	Stage 3: Increase in SCr > 3-fold from baseline or an increase in SCr ≥ 4.0 mg/dL (353.6 μmol/L) with an acute increase ≥ 0.3 mg/dL (26.5 μmol/L) or initiation of renal replacement therapy
Chronic kidney disease (CKD)	Glomerular filtration rate (GFR) of < 60 mL/min for > 3 mo, calculated using the MDRD6 formula. HRS type 2 is a specific form of CKD
Acute-on-chronic kidney disease	Rise in SCr of ≥ 50% from baseline or a rise of SCr by ≥ 0.3 mg/dL (26.5 μmol/L) in < 48 h in a patient with cirrhosis whose GFR is < 60 mL/min for > 3 mo, calculated using the MDRD6 formula

MDRD: Modification in diet of renal disease; GFR: Glomerular filtration rate; CKD: Chronic kidney disease; AKI: Acute kidney injury; SCr: Serum creatinine.