Harmonizing acute and chronic kidney disease definition and classification: report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference

Norbert Lameire* (Corresponding Author), Adeera Levin, John A Kellum, Michael Cheung, Michel Jadoul, Wolfgang C Winkelmayer, Paul E Stevens* (Corresponding Author), Conference Participants

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

173 Citations (Scopus)
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Kidney disease is an important public health problem. Both acute kidney injury (AKI) and chronic kidney disease have been well defined and classified, leading to improved research efforts and subsequent management strategies and recommendations. For those patients with abnormalities in kidney function and/or structure who meet neither the definition of AKI nor chronic kidney disease, there remains a gap in research, care, and guidance. The term acute kidney diseases and disorders, abbreviated to acute kidney disease (AKD), has been introduced as an important construct to address this. To expand and harmonize existing definitions and to ultimately better inform research and clinical care, Kidney Disease: Improving Global Outcomes (KDIGO) organized a consensus workshop. Multiple invitees from around the globe, representing both acute and chronic kidney disease researchers and experts, met virtually to examine existing data, and discuss key concepts related to AKD. Despite some remaining unresolved questions, conference attendees reached general consensus on the definition and classification of AKD, management strategies, and research priorities. AKD is defined by abnormalities of kidney function and/or structure with implications for health and with a duration of <3 months. AKD may include AKI, but, more important, also includes abnormalities in kidney function that are not as severe as AKI or that develop over a period of >7 days. The cause(s) of AKD should be sought, and classification includes functional and structural parameters. Management of AKD is currently based on empirical considerations. A robust research agenda to enable refinement and validation of definitions and classification systems, and thus testing of interventions and strategies, is proposed.

Original languageEnglish
Pages (from-to)516-526
JournalKidney International
Issue number3
Early online date9 Jul 2021
Publication statusPublished - 30 Sept 2021

Bibliographical note

This conference was sponsored by Kidney Disease: Improving Global Outcomes (KDIGO) and was in part supported by unrestricted educational grants from Baxter, bioMérieux, BioPorto, and Kyowa Kirin. We thank Tanya Green and Coral Cyzewski for their assistance with the organization and preparation of the virtual conference.


  • acute kidney disease
  • acute kidney injury
  • hronic kidney disease
  • classification
  • evaluation
  • management
  • staging


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