Advanced CKD after AKI Risk Index

Estimate risk of advanced chronic kidney disease after acute kidney injury

The global unit selector only affects unanswered questions
1.Age?
2.Sex?
3.Baseline Creatinine?
4.Peak Creatinine During Hospitalization?
5.Discharge Creatinine?
6.Albuminuria?
7.In-Hospital Dialysis?
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1. Age?

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About this Calculator

This risk calculator was derived using over 9,000 patients with baseline eGFR ≥45 mL/min/1.73m² who were hospitalized in Alberta, Canada with acute kidney injury (AKI), and was used to predict advanced CKD (sustained eGFR < 30 mL/min/1.73m²) in the subsequent year after discharge from hospital. The models were internally validated in a cohort from Alberta, Canada, and externally validated in a cohort from Ontario, Canada.

Discharge serum creatinine (Scr) is categorized into 5 levels

  • <1.0 mg/dL or <88 μmol/L
  • 1.0 - <1.3 mg/dL or 88 - <114 μmol/L
  • 1.3 - <1.6 mg/dL or 114 - <141 μmol/L
  • 1.6 - <1.9 mg/dL or 141 - <167 μmol/L
  • ≥1.9 mg/dL or ≥167 μmol/L

Acute kidney injury (AKI) severity is determined by comparing peak serum creatinine during hospitalization with baseline creatinine according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria.

AKI stage 1 if Scr increased by ≥0.3 mg/dL (≥26 μmol/L) or peak Scr was 1.5-1.9 times baseline Scr

AKI stage 2 if peak Scr is 2.0-2.9 times baseline Scr

AKI stage=3 if peak Scr ≥3.0 times baseline or peak Scr increased to ≥4.0 mg/dL (≥354 μmol/L), or a patient is treated with dialysis during hospitalization.

Albuminuria is categorized as

  • normal (ACR <30 mg/g [<3.4 mg/mmol] or urine dipstick negative),
  • mild (ACR 30-300 mg/g [3.4-34 mg/mmol] or urine dipstick trace or 1+), or
  • heavy (ACR > 300 mg/g [≥34 mg/mmol] or urine dipstick ≥ 2+).

References

MT James, N Pannu, BR Hemmelgarn, PC Austin, Z Tan, E McArthur, BJ Manns, M Tonelli, R Wald, RR Quinn, P Ravani, Garg AX.

Derivation and External Validation of Prediction Models for Advanced Chronic Kidney Disease following Acute Kidney Injury.

JAMA: the Journal of the American Medical Association 2017 November 14, 318 (18): 1787-1797

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