Per KDIGO 2012 criteria, AKI is defined as which of the following?
- A Serum creatinine rise >1.5 mg/dL from baseline within 7 days
- B Urine output <400 mL/day for 24 consecutive hours
- C Serum creatinine rise ≥0.3 mg/dL within 48 hours OR ≥1.5× baseline within 7 days OR urine output <0.5 mL/kg/h for ≥6 hours ✓
- D eGFR decline ≥25% from baseline within 1 month
Correct answer: C. Serum creatinine rise ≥0.3 mg/dL within 48 hours OR ≥1.5× baseline within 7 days OR urine output <0.5 mL/kg/h for ≥6 hours
Explanation
KDIGO 2012 defines AKI as any of: absolute serum creatinine increase ≥0.3 mg/dL (≥26.5 µmol/L) within 48 hours, or relative creatinine increase ≥1.5× baseline within the prior 7 days, or urine output <0.5 mL/kg/h for ≥6 hours. These three criteria capture AKI at different time-scales. AKI is staged 1–3 based on the degree of creatinine rise or urine output reduction. The 0.3 mg/dL absolute threshold is important because it correlates with mortality even without large relative increases, particularly in patients with low baseline creatinine.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
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