| Urine ACR ratings | AKI Warning Stage 1 | AKI Warning Stage 2 | AKI Warning Stage 3 | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Kidney recovery (SCr % above baseline) | ≤ 25% | >25% & <50% | ≥ 50% | ≤ 25% | >25% & <50% | ≥ 50% | ≤ 25% | >25% & <50% | ≥ 50% | |
| Median (Rating) | Median (Rating) | Median (Rating) | Median (Rating) | Median (Rating) | Median (Rating) | Median (Rating) | Median (Rating) | Median (Rating) | ||
| No past medical history | Not required | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) |
| UACR at 1 Month | 2.5 (I) | 2 (I) | 2 (I) | 2 (E) | 2 (E) | 2 (E) | 2 (E) | 2 (E) | 2 (E) | |
| UACR at 3 Months | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | |
| Chronic kidney disease | Not required | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) |
| UACR at 1 Month | 2.5 (E) | 2.5 (E) | 2.5 (E) | 2.5 (E) | 2.5 (E) | 2.5 (E) | 2.5 (E) | 2.5 (E) | 3 (E) | |
| UACR at 3 Months | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | |
| Chronic heart failure | Not required | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) |
| UACR at 1 Month | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | |
| UACR at 3 Months | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | |
| Chronic kidney disease & chronic heart failure | Not required | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) |
| UACR at 1 Month | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | 3.5 (E) | |
| UACR at 3 Months | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | |
| Other significant cardiovascular risk factors | Not required | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) |
| UACR at 1 Month | 4 (E) | 4 (E) | 4 (E) | 4 (E) | 4 (E) | 4 (D) | 4 (E) | 4 (D) | 4 (D) | |
| UACR at 3 Months | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | |
| Markers of vulnerability | Not required | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) |
| UACR at 1 Month | 3 (E) | 3 (E) | 3 (E) | 3 (E) | 3 (E) | 3 (E) | 3 (E) | 3 (E) | 3 (E) | |
| UACR at 3 Months | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | |
| Other markers of frailty | Not required | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) | 1 (I) |
| UACR at 1 Month | 2 (E) | 2 (E) | 2 (E) | 2 (E) | 2 (E) | 2 (I) | 2 (E) | 2 (E) | 2 (E) | |
| UACR at 3 Months | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) | 9 (A) |
In all urine albumin-to-creatinine ratio scenarios, the highest consensus was to perform the first test at 3 months (all cells coloured green to reflect highest consensus). A = appropriate. AKI = acute kidney injury. D = disagreement. E = equivocal. I = inappropriate. SCr = serum creatinine. U = agreement with uncertain benefit. UACR = urine albumin-to-creatinine ratio.