"improving intensive care in Scotland"

Acute Kidney Injury Part 1:

The RIFLE Classification


  • The RIFLE classification is the consensus classification for acute kidney injury.
  • RIFLE stands for: Risk, Injury, Failure, Loss and End stage kidney disease (ESKD).
  • It is designed to encapsulate the varying degrees of kidney dysfunction (from mild to more severe) and it's criteria are presented in table 1:


Table 1: The RIFLE classification

Class Glomerular filtration rate criteria Urine output criteria

Increased serum creatinine 1.5 x baseline, or

GFR decreased by > 25%

Urine output < 0.5ml/kg/hr for 6 hours


Increased serum creatinine 2 x baseline, or

GFR decreased by > 50%

Urine output < 0.5 ml/kg/hr for 12 hours


Increased serum creatinine 3 x baseline, or

a serum creatinine > 350micromol/l, or

GFR decreased by > 75%

Urine output < 0.3 ml/kg/hr for 24 hours, or

Anuria for 12 hours

Loss Complete loss of kidney function for > 4 weeks
ESKD Persistent loss of kidney function with the requirement for ongoing dialysis for more than 3 months

(GFR = Glomerular Filtration rate)

The criteria (serum creatinine or urine output) that result in the worst possible classification

should be used.

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