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학습 자료 둘러보기 →Diagnose AKI using the KDIGO serum creatinine criteria: a rise of ≥0.3 mg/dL within 48 hours or an increase to ≥1.5 times baseline. This is the most sensitive early indicator of functional decline.
Do not rely on BUN alone for early diagnosis. It is a late and non-specific marker influenced by dehydration, steroids, and GI bleeding. A BUN:Creatinine ratio >20:1 may suggest a pre-renal cause.
Muddy brown casts on urinalysis indicate established acute tubular necrosis (ATN), not early functional AKI. Monitor urine output for oliguria (<0.5 mL/kg/hr for 6 hours), but creatinine changes often precede this.
A single creatinine value is insufficient; always compare to the patient's baseline. In the absence of a known baseline, admit the patient and obtain serial labs to establish a trend.
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