RECOGNITION AND ASSESSMENT

  • CI-AKI is approximately 12% of all cases of hospital-acquired renal failure; defined when one of the following criteria is met:
    • serum creatinine rises >26 µmol/L within 48 hr
    • serum creatinine rises 1.5 fold from baseline value, which is known or presumed to have occurred within 1 week
    • urine output is <0.5 mL/kg/hr for >6 consecutive hr
  • If a baseline serum creatinine within 1 week is not available, use the lowest creatinine value recorded within 3 months of episode of AKI
  • Creatinine typically peaks 3–5 days after contrast administration
    • returns to baseline within 2 weeks
  • Only one in 200 patients requires renal replacement therapy
  • AKI alert will be generated on all inpatients who have U&E and measure in line with the NHS England safety alert (June 2014)

IMMEDIATE TREATMENT

  • No specific treatment
  • Management is supportive. See AKI: management guideline

© 2022 The Bedside Clinical Guidelines Partnership.

Created by University Hospital North Midlands and Keele University School of Computing and Mathematics.

Research and development team: James Mitchell, Ed de Quincey, Charles Pantin, Naveed Mustfa