Published in

Bohn Stafleu van Loghum, Critical Care, 5(13), p. 416

DOI: 10.1186/cc8019

Links

Tools

Export citation

Search in Google Scholar

RIFLE and AKIN - maintain the momentum and the GFR!

Journal article published in 2009 by John W. Pickering ORCID, Zoltan H. Endre
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Green circle
Preprint: archiving allowed
Orange circle
Postprint: archiving restricted
Red circle
Published version: archiving forbidden
Data provided by SHERPA/RoMEO

Abstract

Cruz and colleagues [1] have called appropriately for a reappraisal of RIFLE and AKIN and have thoughtfully detailed many of the issues with these progressive consensus definitions of acute kidney injury (AKI) and with the ways in which they have been applied. They see the elimination of the glomerular filtration rate (GFR) criteria from the AKIN definition as serendipitously discouraging the incorrect use of changes in estimated GFR for AKI diagnosis. We note that it also serendipitously removed the errors in degree of GFR change of the RIFLE R and F criteria definitions compared to the percentage change in creatinine [2]. Nevertheless, we would argue that further refinement of AKI definitions should allow for optional measured changes in GFR to await the possibility that real-time measures of GFR become available. After all, creatinine is merely a surrogate marker for GFR and a poor one at that. Furthermore, the incremental ‘creatinine creep’ type of AKI (0.1 mg/dl/day) illustrated by the authors might then be quickly revealed as incremental injury and loss of GFR.