Template:ICD10 Guideline KDIGO Guidelines for Acute Renal Failure: Difference between revisions
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*Starting January 1, 2019 when we began using ICD10 for diagnosis coding and CCI for procedure coding, we shifted to using the KDIGO criteria for defining Acute Kidney Injury -- which also goes by the names AKI, Acute Renal Failure and Acute Renal Insufficiency | *Starting January 1, 2019 when we began using ICD10 for diagnosis coding and CCI for procedure coding, we shifted to using the KDIGO criteria for defining Acute Kidney Injury -- which also goes by the names AKI, Acute Renal Failure and Acute Renal Insufficiency | ||
*The main thing here is identifying that the observed problem with kidney function is acute, rather than chronic --- and THIS is the reason that identifying AKI requires trying to find a past/baseline value of serum creatinine | *The main thing here is identifying that the observed problem with kidney function is acute, rather than chronic --- and THIS is the reason that identifying AKI requires trying to find a past/baseline value of serum creatinine | ||
*The KDIGO guidelines delineate several different "levels/degrees" of AKI. You'll note that (at its lowest level) AKI is present even with pretty small rises in serum creatinine. While one MIGHT think that such small rises are inconsequential, indeed they are not. As indicated in the paper | *The KDIGO guidelines delineate several different "levels/degrees" of AKI. You'll note that (at its lowest level) AKI is present even with pretty small rises in serum creatinine. While one MIGHT think that such small rises are inconsequential, indeed they are not. As indicated in the paper [https://doi.org/10.1164/rccm.201311-2097OC "Small Acute Increases in Serum Creatinine Are Associated with Decreased Long-Term Survival in the Critically Ill"], even rises in creatinine of 27 mcg/L in ICU patients are associated with higher rates of death. Thus in this new schema we are not ''overcounting'' those with significant AKI, but before we probably were ''undercounting'' them. | ||
*These criteria will apply everywhere we need to identify ARF/AKI -- including: | *These criteria will apply everywhere we need to identify ARF/AKI -- including: | ||
**[[Kidney, acute renal failure NOS]] | **[[Kidney, acute renal failure NOS]] | ||