Table 2.

Suggested definitions of worsening renal function and acute kidney injury

Term and setting	Measure	Temporality	sCr or eGFR	Other criteria
AKI (acute HF)	Relative sCr	Within 1–7 days before or during hospitalization	Increase 1.5–1.9 times baseline sCr within 1–7 days before or during hospitalization	Deterioration in heart failure status or failure to improve or requirement of inotropic support, UF, or RRT
	Absolute sCr	Within 48 hours	≥ 26.5 mmol/L increase in sCr	Deterioration in heart failure status or failure to improve or requirement of inotropic support, UF, or RRT
	Urine output	Over 6–12 hours	Urine output < 0.5 mL/kg/h	Deterioration in heart failure status or failure to improve or requirement of inotropic support, UF, or RRT
Pseudo-AKI (acute HF)	Multiple	Within 1–7 days before or during hospitalization	Not meeting	AKI criteria*
WRF (Chronic HF)	Absolute and relative sCr	Over 1–26 weeks	≥ 26.5 mmol/L and ≥ 25% increase in sCr	Deterioration in HF status but not leading to hospitalization
	eGFR	Over 1–26 weeks	≥ 20% decrease in eGFR	Deterioration in HF status but not leading to hospitalization
Pseudo-WRF	Multiple	Over 1–26 weeks	Not meeting	WRF criteria*

AKI definitions do not include eGFR because eGFR calculations assume steady-state renal function.

AKI, acute kidney injury; eGFR, estimated glomerular filtration rate; HF, heart failure; RRT, renal replacement therapy; sCr, serum creatinine; UF, ultrafiltration; WRF, worsening renal function.

^*Damman et al.³ suggest that doubling or a > 88.4 μmol/L rise in serum creatinine should trigger further investigation even if falling into the pseudo-AKI or pseudo-WRF categories.

Modified from Damman et al.³ with permission from Oxford University Press.