RIFLE Criteria for Acute Kidney Injury (AKI) Online calculator
Classifies severity of acute kidney injury.
The RIFLE score сclassifies the severity of acute kidney injury as the AKIN classification.
The RIFLE score includes:
- Presence or absence of end-stage renal disease (being on dialysis for more than 3 months)
- Presence or absence of persistent acute kidney injury – more than 4 weeks on renal replacement therapy
- Serum creatinine
- Having end-stage renal disease (more than 3 months on dialysis) is classified as End Stage, RIFLE-E
- Presence of persistent acute kidney injury – on renal replacement therapy for more than 4 weeks is classified as Loss, RIFLE-L
Other criteria are evaluated by the worst parameter of serum creatinine, GFR and Urine output (details in the table).
|RIFLE Criteria||Serum creatinine||GFR||Urine output|
|Risk, RIFLE-R||1.5-2x above baseline||>25% decrease below baseline||<0.5 mL/kg/hr x 6 hr|
|Injury, RIFLE-I||>2–3x above baseline||>50% decrease below baseline||<0.5 mL/kg/hr x 12 hr|
|Failure, RIFLE-F (RIFLE-FO if oliguria)||>3x above baseline, ≥4 mg/dL (350 µmol/L), or acute rise ≥0.5 mg/dL (44 µmol/L)||>75% decrease below baseline||<0.3 mL/kg/hr x 24 hr (oliguria), or anuria x 12 hrs|
|Loss, RIFLE-L||Persistent AKI (on renal replacement therapy for >4 weeks)|
|ESRD, RIFLE-E||End stage renal disease (on dialysis for >3 months)|
AKI may be present even with “normal” serum creatinine, if GFR is decreased, or if creatinine is significantly elevated above baseline.
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- Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8(4): R204-12.
- Van Biesen W, Vanholder R, Lameire N. Defining acute renal failure: RIFLE and beyond. Clin J Am Soc Nephrol. 2006;1(6):1314-9.
- Lopes JA, Jorge S. The RIFLE and AKIN classifications for acute kidney injury: a critical and comprehensive review. Clinical Kidney Journal. 2013;6(1):8-14. doi:10.1093/ckj/sfs160.
- Xiong J, Tang X, Hu Z, Nie L, Wang Y, Zhao J. The RIFLE versus AKIN classification for incidence and mortality of acute kidney injury in critical ill patients: A meta-analysis. Sci Rep. 2015;5:17917.
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