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(3) Measure Specifications The numerator is inpatient hospitalizations for patients 18 years and older who develop AKI (stage 2 or greater) during the encounter, as evidenced by: (1) a subsequent increase in the serum creatinine value at least 2 times higher than the lowest serum creatinine value, and the increased value is greater than the highest sex-specific normal value for serum creatinine or (2) kidney dialysis (hemodialysis or peritoneal dialysis) initiated 48 hours or more after the start of the encounter

These may act as signaling metabolites with anti-tumor effects by engaging G-protein receptors and inhibiting class-I histone deacetylases, altering gene expression, and dampening PI3KAKT-mTOR signaling 354,355

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A sterile diluent such as bacteriostatic water or a recommended reconstitution solution is advisable