The KDIGO has not been the focus of any CICM exam questions.
It was first published as a guidelines statement in 2012. It is essentially a combined RIFLE/AKIN system, incorporating the better elements of both, and thus unfortunately also retaining their defects.
A lukewarm response from the Americans published in 2013 serves as an excellent summary of the KDIGO recommendation statements, and a source for much of the critiques.
The abovementioned American Response has within it a handy summary box (Box 1, p.653).
|Serum creatinine criteria||Urine output criteria|
|Creatinine × 1.5 - 1.9 from baseline over 7 days
Creatinine increased by at least 26.4μmol/L over 48 hrs
|u/o < 0.5ml/kg/hr × 6-12 hours|
|Creatinine × 2.0-2.9 (i.e. doubled or tripled creatinine)||u/o < 0.5ml/kg/hr × more than 12 hrs|
|Creatinine × 3.0
An increase up to a creatinine of 354 μmol/L or more
The initiation of RRT
In patients <18 years, decrease in eGFR to <35 ml/min
|u/o < 0.3ml/kg/hr × 24 hrs
Anuria for 12 hours
One might say that this is damn near identical to the AKIN classifications.
That is indeed accurate.
The definition of AKI in general is only slightly different.
Lopes et al have published "a critical and comprehensive review" of the RIFLE and AKIN criteria in 2012. This summary owes much to their article.
Bellomo, Rinaldo, et al. "Acute renal failure–definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group." Critical care 8.4 (2004): R204.
Cruz, Dinna N., Zaccaria Ricci, and Claudio Ronco. "Clinical review: RIFLE and AKIN–time for reappraisal." Critical care 13.3 (2009): 211.
Hoste, Eric AJ, and John A. Kellum. "Acute kidney injury: epidemiology and diagnostic criteria." Current opinion in critical care 12.6 (2006): 531-537.
Chertow, Glenn M., et al. "Acute kidney injury, mortality, length of stay, and costs in hospitalized patients." Journal of the American Society of Nephrology16.11 (2005): 3365-3370.
Lopes, José António, and Sofia Jorge. "The RIFLE and AKIN classifications for acute kidney injury: a critical and comprehensive review." Clinical Kidney Journal 6.1 (2013): 8-14.
Coca, Steven G., et al. "The duration of postoperative acute kidney injury is an additional parameter predicting long-term survival in diabetic veterans." Kidney international 78.9 (2010): 926-933.