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Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury

Ravindra L Mehta1*, John A Kellum2, Sudhir V Shah3, Bruce A Molitoris4, Claudio Ronco5, David G Warnock6, Adeera Levin7 and the Acute Kidney Injury Network

Author Affiliations

1 Department of Medicine, University of California San Diego Medical Center 8342, 200 W. Arbor Drive, San Diego, CA 92103, USA

2 Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, 608 Scaife Hall, Pittsburgh, PA 15261, USA

3 Division of Nephrology, UAMS College of Medicine, 4301 West Markham, Slot 501, Little Rock, AR 72205, USA

4 Department of Medicine, Indiana University, Indianapolis, IN, USA

5 Department of Nephrology Dialysis & Transplantation, San Bortolo Hospital, Vicenza, Italy

6 Department of Medicine, University of Alabama, 1900 University Blvd, Birmingham, AL, USA

7 Department of Medicine, University of British Columbia, St Pauls Hospital, 1160 Burrard St, Vancouver BC, V6Z1Y8, Canada

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Critical Care 2007, 11:R31  doi:10.1186/cc5713

Acute Kidney Injury Network participants: Arvind Bagga, Aysin Bakkaloglu, Joseph V Bonventre, Emmanuel A Burdmann, Yipu Chen, Prasad Devarajan, Vince D’Intini, Geoff Dobb, Charles G Durbin Jr., Kai-Uwe Eckardt, Claude Guerin, Stefan Herget-Rosenthal, Eric Hoste, Michael Joannidis, John A Kellum, Ashok Kirpalani, Andrea Lassnigg, Jean-Roger Le Gall, Adeera Levin, Raul Lombardi, William Macias, Constantine Manthous, Ravindra L Mehta, Bruce A Molitoris, Claudio Ronco, Miet Schetz, Frederique Schortgen, Sudhir V Shah, Patrick SK Tan, Haiyan Wang, David G Warnock and Steve Webb. See related letter by Lippi and Guidi,

Published: 1 March 2007



Acute kidney injury (AKI) is a complex disorder for which currently there is no accepted definition. Having a uniform standard for diagnosing and classifying AKI would enhance our ability to manage these patients. Future clinical and translational research in AKI will require collaborative networks of investigators drawn from various disciplines, dissemination of information via multidisciplinary joint conferences and publications, and improved translation of knowledge from pre-clinical research. We describe an initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI.


Members representing key societies in critical care and nephrology along with additional experts in adult and pediatric AKI participated in a two day conference in Amsterdam, The Netherlands, in September 2005 and were assigned to one of three workgroups. Each group's discussions formed the basis for draft recommendations that were later refined and improved during discussion with the larger group. Dissenting opinions were also noted. The final draft recommendations were circulated to all participants and subsequently agreed upon as the consensus recommendations for this report. Participating societies endorsed the recommendations and agreed to help disseminate the results.


The term AKI is proposed to represent the entire spectrum of acute renal failure. Diagnostic criteria for AKI are proposed based on acute alterations in serum creatinine or urine output. A staging system for AKI which reflects quantitative changes in serum creatinine and urine output has been developed.


We describe the formation of a multidisciplinary collaborative network focused on AKI. We have proposed uniform standards for diagnosing and classifying AKI which will need to be validated in future studies. The Acute Kidney Injury Network offers a mechanism for proceeding with efforts to improve patient outcomes.