Renal Angina Index (Predicting Severe AKI in Children)
The Renal Angina Index (Basu and colleagues 2014) predicts severe acute kidney injury on day 3 in a critically ill child, scored at about 12 hours after intensive care admission, before the creatinine has moved.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Risk stratum
- 3
- Injury stratum, from whichever route is worse
- 4
Result: RAI 12, renal angina fulfilled.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Risk
- 1 for ICU admission, 3 for solid-organ or stem-cell transplant, 5 for invasive ventilation AND vasoactive support within 12 hours.
- Injury
- 1, 2, 4, or 8 from whichever is worse of the eCrCl fall or the percentage fluid overload.
- Combination
- Risk multiplied by injury, not added. Only twelve totals are reachable: 1, 2, 3, 4, 5, 6, 8, 10, 12, 20, 24, 40.
- 8 or more
- Renal angina fulfilled.
- Design
- A rule-out, with a high negative predictive value and a modest positive predictive value. It predicts day-3 severe AKI rather than staging an injury.
What you enter
- Risk stratum
- Injury stratum, from whichever route is worse.
Full field descriptions
- Risk stratum [1 - admitted to the intensive care unit (and not meeting a higher tier); 3 - history of solid-organ or stem-cell transplant; 5 - invasive mechanical ventilation AND vasoactive or inotropic support within the first 12 hours (both, though not necessarily at the same moment)]
- Injury stratum, from whichever route is worse. NOTE the tiers DOUBLE - the only valid values are 1, 2, 4 and 8, and there is no 3, 5, 6 or 7 [1 - no decrease in estimated creatinine clearance, or fluid overload below 5 percent; 2 - eCrCl decrease of 0 to under 25 percent, or fluid overload of 5 to under 10 percent; 4 - eCrCl decrease of 25 to under 50 percent, or fluid overload of 10 to under 15 percent; 8 - eCrCl decrease of 50 percent or more, or fluid overload of 15 percent or more]
How this is calculated
Basu RK, Zappitelli M, Brunner L, et al. Derivation and validation of the renal angina index to improve the prediction of acute kidney injury in critically ill children. Kidney Int. 2014;85(3):659-667. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.