Hi, At the Royal Liverpool Hospital, we have been working extensively with our LIMS supplier (iSoft iLab.TP, TelePath) to detect acute kidney injury (AKI) in real-time. KDIGO guidelines recommend staging the condition according to changes in creatinine over 48 hours or a reference interval of 90 days (table below). Stage Serum creatinine (SCr) criteria Urine output criteria 1 increase ¡Ã 26 ¥ìmol/L within 48hrs or increase ¡Ã1.5 to 1.9 X reference SCr <0.5 mL/kg/hr for > 6 consecutive hrs 2 increase ¡Ã 2 to 2.9 X reference SCr <0.5 mL/kg/ hr for > 12 hrs 3 increase ¡Ã3 X reference SCr or increase ¡Ã354 ¥ìmol/L or commenced on renal replacement therapy (RRT) irrespective of stage <0.3 mL/kg/ hr for > 24 hrs or anuria for 12 hrs We are in the advanced stages of quality controlling this development and are seeking clarification on AKI Stage 3; do creatinine values have to attain a level of 354 umol/L or does the change from the reference creatinine within the 90 day period need to be 354 umol/L? There are varying opinions about this. There is also the issue of when a patient presents for the first time, when an AKI check cannot be performed and when there is a potential acute on chronic re-admission. We have some ideas on how this could be potentially detected, but would welcome feedback from others. Please respond directly and I will happily present a collated report to those interested. Best wishes, Adrian ___________________________________________ Dr Adrian G Miller BSc MSc PhD Senior Clinical Biochemist Department of Clinical Biochemistry & Metabolic Medicine 4th Floor, Duncan Building Royal Liverpool and Broadgreen University NHS Trust Daulby Road Liverpool L7 8XP Tel. 0151 706 4163 Mobile e-mail: [log in to unmask]<mailto:[log in to unmask]> ******************************************************************************************************************** This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Thank you for your co-operation. NHSmail is the secure email and directory service available for all NHS staff in England and Scotland NHSmail is approved for exchanging patient data and other sensitive information with NHSmail and GSi recipients NHSmail provides an email address for your career in the NHS and can be accessed anywhere For more information and to find out how you can switch, visit www.connectingforhealth.nhs.uk/nhsmail ******************************************************************************************************************** ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/