Why was an absolute creatinine level removed from the diagnostic criteria for AKI-HRS?
The current diagnostic criteria for AKI-HRS do not specify an absolute creatinine level. Serum creatinine is not an accurate measurement in patients with cirrhosis.
In cirrhosis, low protein intake, loss of muscle mass, diminished hepatic synthesis of creatine, and an enlarged volume of distribution, all lower the serum creatinine irrespective of kidney function.
This can delay the recognition of kidney dysfunction and have a negative impact on patient outcomes. Using a change in serum creatinine allows an earlier diagnosis of AKI and more timely intervention. This may lead to improved outcomes.