Background and importance Different criteria were created to identify acute kidney injury (AKI) based on serum creatinine (SCr) levels, namely AKIN, KDIGO, RIFLE.

Aim and objectives To assess the ability to monitor AKI occurrence based on the availability of timely measured SCr levels in a retrospective cohort of patients admitted to hospital.

Material and methods Data from patients admitted to hospital between 1 June 2018 and 31 December 2020 were collected. AKI stage was calculated for each patient based on the AKI staging cut-offs using the three major guidelines (RIFLE, AKIN and KDIGO) and five criteria. In a first analysis, time to reach the SCr cut-off was ignored. In a second analysis, patients reaching any AKI stage were re-evaluated considering the time recommended between SCr tests: 48 hours AKIN and 7 days RIFLE and KDIGO. Descriptive analyses of the AKI stage allocation were performed.

Results During 31 months, 25 777 admissions occurred corresponding to 18 935 patients (4112 patients with more than 1 admission; range 1–18). Mean age of admissions was 60 years (SD 27), 14 146 (54.9%) were female and the mean length of stay was 10 days (SD 16); 63 admissions had a duration <24 hours. During 263 969 bed-days, 81 892 SCr tests were recorded, representing 1 test per 3.22 bed-days. In 4407 admissions (17.1%) no SCr test was recorded. The first SCr test was done on average 2.2 days (SD 2) after admission. A total of 6958 tests increased 0.3 mg/dL from baseline and 1500 tests increased 1.5–2 times their value (stage 1); of these, 1689 and 323 exceeded the 48 hours, and 103 and 29 the 7 day-interval, respectively. In 1618 tests, baseline increased 2–3 times (stage 2) with 363 over 48 hours and 33 over the 7-day interval. In 477 tests, baseline increased more than three times and in 166 increased 4.0 mg/dL (stage 3), where 105 and 39 were over 48 hours and 10 and 4 were over the 7-day interval, respectively.

Conclusion and relevance To accurately monitor AKI, hospital pharmacists need access to SCr levels of inpatients measured at least every 48 hours.

References and/or acknowledgements 1. Sutherland L, et al. Nephrology 2020;25(3):212–218.

Conflict of interest No conflict of interest