Stage	Serum creatinine (SCr) criteria	Urine output criteria
1	increase ≥ 26 μmol/L within 48hrs or increase ≥1.5 to 1.9 X reference SCr	<0.5 mL/kg/hr for > 6 consecutive hrs
2	increase ≥ 2 to 2.9 X reference SCr	<0.5 mL/kg/ hr for > 12 hrs
3	increase ≥3 X reference SCr or increase ≥354 μmol/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.