Advanced CKD after AKI Risk Index

About this tool

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. 2017 Nov 14;318(18):1787-1797. doi: 10.1001/jama.2017.16326.