Kidney Disease: Improving Global Outcomes (KDIGO) defines Acute Kidney Injury using the following criteria:
- Increase Creatinine greater than or equal to 0.3mg/dl from baseline within 48 hours; or
- Increase in Creatinine greater than or equal to 1.5 times baseline, which is known or presumed to have occurred within 7 days; or
- Urine output less than 0.5ml/kg/hr for 6 hours.
The KDIGO criterion is used for ICD -10 coding of AKI. If a patient baseline creatinine is unknown. “The lowest creatinine level obtained during a hospitalization is usually equal to or greater than the baseline. This SCr should be used to diagnosis AKI.” (Pinson;Tang, 2015)
Example: Patient SCr levels during hospitalization as follows:
- Day 1: SCr 1.69
- Day 2: SCr 1.52
- Day 3: SCr 1.31
- Day 4: SCr 0.98
Above patient meets criteria for AKI per KDIGO criterion.
If patients Creatinine returns to baseline within 24 hours after administration of IV fluids, patient will not meet criteria for AKI.
Official Journal of the International Society of Nephrology. (2012 KDIGO Clinical Practice Guideline for Acute Kidney Injury.) Vol 2 (1). Retrieved from http://www.kidney-international.org.
Pinson,R., Tang,C. (2015). 2016 CDI Pocket Guide. P 53-54.