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[Correspondence] The definition of acute kidney injury

We read with interest the Comment in The Lancet by Jon Barasch and colleagues (Feb 25, 2017, p 779)1 with its controversial title “Acute kidney injury: a problem of definition”. We appreciate the opportunity to clarify what is written in the Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline on acute kidney injury (AKI),2 in the hope that clinicians will read beyond the headlines. The guideline clearly states that AKI is a clinical diagnosis and stresses the importance of clinical judgment: “While the definitions and classification system discussed in Chapter 2.1 provide a framework for the clinical diagnosis of AKI, they should not be interpreted to replace or to exclude clinical judgment”.

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