Acute renal failure classification
|
Acute renal failure Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Acute renal failure classification On the Web |
|
American Roentgen Ray Society Images of Acute renal failure classification |
|
Risk calculators and risk factors for Acute renal failure classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
Acute renal failure can complicate a wide spectrum of disorders, and for the purpose of diagnosis and management is divided according to the mechanism that lead to renal compromise. The three categories are pre-renal azotemia (diseases that cause renal hypoperfusion), renal azotemia (diseases directly affecting the renal parenchyma), and post-renal azotemia (diseases affecting the urinary tract causing obstruction).
Classification
According to the levels of renal dysfunction
Acute renal failure is usually categorised (as in the flowchart below) according to pre-renal, renal and post-renal causes.
| Acute Renal Failure | |||||||||||||||||||||||||||||||||
| Pre-renal | Renal | Post-renal | |||||||||||||||||||||||||||||||
1. Pre-renal
- Compromise in the renal blood flow
2. Renal
- Damage to the kidney itself
3. Post-renal
- Obstructive causes in the urinary tract
According to the RIFLE criteria
The RIFLE (Risk of renal dysfunction, Injury to the kidney, Failure or Loss of kidney function, and End-stage kidney disease) criteria classifies acute renal failure according to the probable clinical outcomes[1][2]. This system is increasingly used for evaluation of patients with acute kidney injury.
- Risk: GFR decrease >25%, serum creatinine increased 1.5 times or urine production of <0.5 ml/kg/hr for 6 hours
- Injury: GFR decrease >50%, doubling of creatinine or urine production <0.5 ml/kg/hr for 12 hours
- Failure: GFR decrease >75%, tripling of creatinine or creatinine >355 μmol/l (with a rise of >44) (>4 mg/dl) OR urine output below 0.3 ml/kg/hr for 24 hours
- Loss: persistent AKI or complete loss of kidney function for more than 4 weeks
- End-stage renal disease: need for renal replacement therapy (RRT) for more than 3 months
References
- ↑ Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P (2004). "Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group". Critical Care (London, England). 8 (4): R204–12. doi:10.1186/cc2872. PMC 522841. PMID 15312219. Unknown parameter
|month=ignored (help) - ↑ Lameire N, Van Biesen W, Vanholder R (2005). "Acute renal failure". Lancet. 365 (9457): 417–30. doi:10.1016/S0140-6736(05)17831-3. PMID 15680458.