AKIN Classification for Acute Kidney Injury
Acute Kidney Injury Network (AKIN) staging for AKI. Modification of RIFLE criteria using serum creatinine and urine output over 48 hours.
Score interpretation
No AKIN criteria met — no acute kidney injury
→ Monitor renal function; optimise fluid status; nephrotoxin avoidance
Stage 1 — mild AKI. Creatinine 1.5–1.9× or rise ≥26.5 μmol/L; or UO <0.5 mL/kg/h for >6h
→ Review fluid status; withhold nephrotoxins (NSAIDs, aminoglycosides, iodinated contrast); check urine dipstick; renal function daily
Stage 2 — moderate AKI. Creatinine 2–2.9× baseline or UO <0.5 mL/kg/h for >12h
→ Nephrology review; IV fluids if pre-renal; consider renal replacement therapy threshold; avoid nephrotoxins; stop NSAIDs/ACEi/ARBs; daily FBC/U&E
Stage 3 — severe AKI. Creatinine ≥3× or ≥354 μmol/L or RRT initiated
→ ICU/HDU care; urgent nephrology; consider RRT (haemodialysis, CVVHF); manage complications (hyperkalaemia, fluid overload, acidosis); monitor for MODS
Interpretation bands for the AKIN Criteria. Apply clinical judgement and local guidance.
References
- Mehta RL et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11(2):R31.
Related
Curated clinical cross-links plus same-class fallbacks.
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Milrinone · Inodilator / Acute Heart Failure
- Prednisolone (Systemic) · Systemic Corticosteroid — Acute Dermatoses
- Methoxyflurane · Inhaled Analgesic — Acute Pain
- Colchicine (Acute Gout) · Anti-Inflammatory (Microtubule Inhibitor)
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.