A 60-year-old man on ICU has chronic kidney disease (baseline creatinine 250 µmol/L, eGFR 22 mL/min). He develops sepsis and his creatinine rises to 3...

Question

A 60-year-old man on ICU has chronic kidney disease (baseline creatinine 250 µmol/L, eGFR 22 mL/min). He develops sepsis and his creatinine rises to 380 µmol/L over 48 hours. His urine output has been 0.3 mL/kg/hr for 18 hours. According to KDIGO, how should AKI be staged when there is pre-existing CKD?

Accepted Answer

Use the patient's known baseline creatinine (250 µmol/L) as the reference for staging - the rise to 380 µmol/L is 1.52× baseline (Stage 1)

Answer

AKI cannot be diagnosed in patients with pre-existing CKD

Answer

Use a 'normal' creatinine of 80 µmol/L as baseline for staging

Answer

Stage based on absolute creatinine value alone - 380 µmol/L is always Stage 3

Answer

Ignore creatinine and stage by urine output criteria only

uk-fficm MCQ (SBA): Acute-on-Chronic Kidney Injury