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Updated: Oct 27, 2025
09:02
A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Developing an AKI Consensus Definition for Database Research: Findings From a Scoping Review and Expert Opinion Using
Greg Guthrie1, Bruce Guthrie2, Heather Walker3
1Renal Unit, Ninewells Hospital, Dundee, United Kingdom.
Summary
Defining acute kidney injury (AKI) using routinely collected health data is inconsistent. This study aimed to standardize AKI research definitions, but experts achieved limited consensus, highlighting the need for updated KDIGO guidelines.
Area of Science:
- Nephrology
- Epidemiology
- Health Informatics
Background:
- The Kidney Disease: Improving Global Outcomes (KDIGO) definition for acute kidney injury (AKI) is widely used in epidemiological studies.
- However, its application to routinely collected healthcare data shows significant variability and inconsistent methodology.
- This inconsistency hinders accurate AKI research and surveillance.
Purpose of the Study:
- To examine the variation in applying the KDIGO AKI definition to routinely collected healthcare data.
- To achieve expert consensus on standardized definitions for AKI research using such data.
Main Methods:
- A scoping review of 174 studies using Medline and EMBASE was conducted.
- An international expert panel participated in a modified Delphi process with two rounds of questionnaires.
- Consensus was defined as 75% agreement.
Main Results:
- The scoping review revealed inconsistent application and poor description of KDIGO AKI definition methods in 174 studies.
- Over a third of studies (33%) did not define the baseline creatinine, and 80% failed to define kidney function recovery.
- The Delphi process achieved partial consensus on baseline creatinine, patient exclusion criteria, and defining non-recovery of AKI.
Conclusions:
- Current methods for defining AKI in routinely collected data are inconsistent and poorly reported.
- Experts could not reach full consensus on many aspects of AKI definition and sequelae.
- The KDIGO guidelines require extension to provide standardized definitions for AKI research using routinely collected data.
Keywords:
Acute kidney injury (AKI)Delphi processKDIGO definitionbaseline creatininecommunity-acquired AKIconsensusdatadiagnostic criteriamethodological transparencynephrology research methodsoutcome assessmentrenal functionreporting recommendationsreproducibilityreviewserum creatininestandardized outcomeurine output
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