Renal dysfunction in patients with cirrhosis: Where do we stand?

Table 2 Acute kidney injury network and risk, injury, failure, loss, and end stage criteria for the diagnosis of acute kidney injury[117]

AKIN criteria	Urine output	RIFLE criteria
Serum creatinine	(common to both AKIN and RIFLE)	Class	Serum creatinine or GFR
Stage 1
Increase of more than or equal to 0.3 mg/dL (≥ 26.5 μmol/L) or increase to more than or equal to 150% to 199% (1.5- to 1.9-fold) from baseline	Less than 0.5 mL/kg per hour for more than 6 h	Risk	Increase in serum creatinine × 1.5 or GFR decrease > 25%
Stage 2
Increased to more than 200% to 300% (≥ 2- to 2.9-fold) from baseline	Less than 0.5 mL/kg per hour for more than 12 h	Injury	Serum creatinine × 2 or GFR decreased > 50%
Stage 3
Increased to more than 300% (≥ 3-fold) from baseline, or more than or equal to 4.0 mg/dL (≥ 354 μmol/L) with an acute increase of at least 0.5 mg/dL (44 μmol/L) or on RRT	Less than 0.3 mL/kg per hour for 24 h or anuria for 12 h	Failure	Serum creatinine × 3, or serum creatinine > 4 mg/dL (> 354 μmol/L) with an acute rise > 0.5 mg/dL (> 44 μmol/L) or GFR decreased > 75%
		Loss	Persistent acute renal failure = complete loss of kidney function > 4 wk
		End-stage kidney disease	ESRD > 3 mo

For conversion of creatinine expressed in SI units to mg/dl, divide by 88.4. For both AKIN stage and RIFLE criteria, only one criterion (creatinine rise or urine output decline) needs to be fulfilled. Class is based on the worst of either GFR or urine output criteria. GFR decrease is calculated from the increase in serum creatinine above baseline. For AKIN, the increase in creatinine must occur in < 48 h. For RIFLE, AKI should be both abrupt (within 1–7 d) and sustained (more than 24 h). AKI: Acute kidney injury; AKIN: Acute Kidney Injury Network; ESRD: End-stage renal disease; GFR: Glomerular filtration rate; RIFLE: Risk, injury, failure, loss, and end stage; RRT: Renal replacement therapy.