Drug-Induced AKI: KDIGO Stage and Risk Factors

Stage acute kidney injury from creatinine, urine output and dialysis, and record the risk modifiers described in Chapter 3.

Pre-existing renal impairment (chronic kidney disease)Volume depletion, heart failure, cirrhosis or diuretic use“Triple whammy”: NSAID + ACE inhibitor or ARB + diuretic (highest risk in the first 30 days)Age over 65 years (contrast nephropathy risk rises further above 75)Two or more nephrotoxic drugs together, e.g. aminoglycoside + vancomycin, aminoglycoside + amphotericin B, cisplatin + aminoglycoside, NSAID + contrast within 48 h, calcineurin inhibitor + aminoglycosideHigh dose or long duration of a directly nephrotoxic drug, e.g. aminoglycoside for more than 7 days or trough above 2 µg/mL, cisplatin cumulative dose around 300 mg/m², amphotericin B deoxycholate total above 2–3 gDose not adjusted to kidney function (for example aminoglycosides, methotrexate, acyclovir)

The book describes these modifiers but does not give them points, so the tool counts them and does not produce a risk score. Stage the injury on the worst criterion met.