Wiersema R, Koeze J, Eck RJ, et al. - Since Acute Kidney Injury (AKI) confers a markedly increased morbidity and mortality in critically ill patients, therefore, researchers undertook this sub-study of the Simple Intensive Care Studies-I—a prospective observational cohort study of critically ill patients acutely admitted to ICU—to confirm if clinical examination in critically ill patients holds predictive value for AKI development. Within 24 hours of ICU admission, a clinical examination was carried out. This analysis included 1,003 patients (93%). Factors that showed a link with AKI were increased heart rate, subjectively cold extremities and a prolonged capillary refill time on the sternum. An area under the receiver-operating curve of 0.70 was generated in this multivariable analysis. The inclusion of lactate resulted in a better performance of the model. Overall, AKI prediction with moderate accuracy was enabled by clinical examination findings in a large cohort of critically ill patients.