Acute kidney injury staging by serum creatinine and urine output
Baseline serum creatinine (mg/dL)
Current serum creatinine (mg/dL)
Creatinine rose within the last 48 hours
Renal replacement therapy started
Urine output
≥ 0.5 mL/kg/h (normal)
< 0.5 mL/kg/h for 6–12 hours
< 0.5 mL/kg/h for 12–24 hours
< 0.3 mL/kg/h for ≥ 24 hours, or anuria for ≥ 12 hours
Enter the baseline and current creatinine
Evidence
Original publication
Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury (2012), summarised by Khwaja A, KDIGO clinical practice guidelines for acute kidney injury. Unified the RIFLE and AKIN definitions into a single creatinine- and urine-output-based staging system (stages 1–3).
Nephron Clinical Practice, 2012
Open source
Guideline
Stage is the higher of the creatinine and urine-output stages. Management is staged: in all stages stop nephrotoxins, optimise volume status and perfusion pressure, and monitor creatinine and urine output; higher stages prompt review for renal replacement therapy and specialist input. Baseline creatinine may be a documented value or an estimate; urine output requires an accurate weight and timed collection.
Last reviewed: 2026-09
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