James et al reported a model for predicting advanced chronic kidney disease following an episode of acute kidney injury. The authors are from multiple institutions in Canada.
Patient selection: acute kidney injury
Parameters:
(1) age in years
(2) sex
(3) baseline serum creatinine in mg/dL
(4) albuminuria
(5) acute kidney injury stage
(6) discharge serum creatinine in mg/dL
|
Parameter |
Finding |
Points |
|
age in years |
< 50 |
0 |
|
|
50 to 59 |
1 |
|
|
60 to 69 |
2 |
|
|
70 to 79 |
2 |
|
|
80 to 89 |
2 |
|
|
>= 90 |
3 |
|
sex |
male |
0 |
|
|
female |
3 |
|
baseline creatinine |
< 0.6 |
0 |
|
|
0.6 to 0.69 |
1 |
|
|
0.7 to 0.79 |
1 |
|
|
0.8 to 0.89 |
2 |
|
|
0.9 to 0.99 |
2 |
|
|
1.0 to 1.09 |
3 |
|
|
1.1 to 1.19 |
3 |
|
|
1.2 to 1.29 |
4 |
|
|
>= 1.3 |
5 |
|
albuminuria |
normal |
0 |
|
|
mild |
1 |
|
|
heavy |
3 |
|
|
not measured |
1 |
|
AKI stage |
1 |
0 |
|
|
2 |
1 |
|
|
3 |
3 |
|
discharge creatinine |
< 1.0 |
0 |
|
|
1.0 to 1.29 |
3 |
|
|
1.3 to 1.59 |
6 |
|
|
1.6 to 1.89 |
7 |
|
|
>= 1.9 |
11 |
where:
• Normal albuminuria: albumin to creatinine ratio < 30 mg/g or negative dipstick.
• Mild albuminuria: albumin to creatinine ratio 30 to 300 mg/g; dispstick trace or 1+
• Severe albuminuria: albumin to creatinine ratio > 300 mg/g or dipstiack >= 2+
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 28
|
Total Score |
Risk Advanced CKD |
|
<= 8 |
< 1% |
|
9 to 14 |
1 to 4.9% |
|
15 to 17 |
5 to 9.9% |
|
18 or 19 |
10 to 19.9% |
|
>= 20 |
>= 20% |
Specialty: Nephrology
