Acute kidney injury

back arrow icon Back to Nursing Essentials Crib Cards


Acute kidney injury (AKI) describes a rapid deterioration in a patient’s renal function over a few hours/days. One in five emergency admissions to hospital will have AKI and around 30% of AKI cases could be preventable.


AKI can be classified in three stages of severity: 

Stage  Serum creatinine Urine output* 
 1  Increase by ≥ 26 micromol/L within 48 hours OR 1.5-1.9 times baseline  <0.5 ml/kg/h for 6-12 hours 
 2  2.9 times baseline <0.5 ml/kg/h for ≥12 hours  <0.5 ml/kg/h for ≥12 hours
 3  3 times baseline OR Increase to ≥354 micromol/L OR Decrease in eGFR to <35 ml /min OR Initiation of renal replacement therapy  <0.3 ml/kg/h for ≥24 hours


Responding to AKI

If you suspect AKI alert a senior colleague. You may be requested to perform urine dipstick and send for MSU, take further blood tests and report these to a senior colleague. The team may consider urinary catheterisation and review all medications.

Learn more by completing the NICE AKI module at:

*Accurate monitoring and recording of fluid balance including urine output is essential.