Cardiac Surgery-Associated Acute Kidney Injury: A Comparison of Two Consensus Criteria

Robert, Alina M.; Kramer, Robert S.; Dacey, Lawrence J.; Charlesworth, D.; Leavitt, Bruce J.; Helm, Robert E.; Hernandez, Felix; Sardella, Gerald L.; Frumiento, Carmine; Likosky, Donald S.; Brown, Jeremiah R.

doi:10.1016/j.athoracsur.2010.08.018

Cited by 151 publications

(115 citation statements)

References 12 publications

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“…However, AKI incidence using KDIGO definition is probably lower than that using AKIN and RIFLE. Reported incidences of AKI in different studies ranged from 26%-49% for AKIN [55,60] , 19%-30% for RIFLE [55,60] and 15%-16% for KDIGO [63,64] . Thanks to the development of consensus systems for the definition of AKI, it is possible currently to compare studies around the world and newer definitions have improved their employment in cardiac patients.…”

Section: Aki Definition Systems: Rifle Akin and Kdigomentioning

confidence: 99%

“…Despite the recognized importance of AKI, one of the major problems in conducting studies on the subject is system, the resultant debate over the supremacy of each criterion prompted comparative research [55][56][57][58][59][60] , which disclosed that AKIN was not more efficient than RIFLE and that some authors still preferred to employ RIFLE with some modifications [55] . Modified RIFLE stages anyone who needs RRT in category F (failure) regardless of the level of serum creatinine.…”

Section: Aki Definition Systems: Rifle Akin and Kdigomentioning

confidence: 99%

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Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Najafi

2014

WJC

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Serum creatinine is still the most important determinant in the assessment of perioperative renal function and in the prediction of adverse outcome in cardiac surgery. Many biomarkers have been studied to date; still, there is no surrogate for serum creatinine measurement in clinical practice because it is feasible and inexpensive. High levels of serum creatinine and its equivalents have been the most important preoperative risk factor for postoperative renal injury. Moreover, creatinine is the mainstay in predicting risk models and risk factor reduction has enhanced its importance in outcome prediction. The future perspective is the development of new definitions and novel tools for the early diagnosis of acute kidney injury largely based on serum creatinine and a panel of novel biomarkers.

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Section: Aki Definition Systems: Rifle Akin and Kdigomentioning

confidence: 99%

Section: Aki Definition Systems: Rifle Akin and Kdigomentioning

confidence: 99%

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Najafi

2014

WJC

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“…Of importance, in the AKIN classification, AKI diagnosis was based on changes over the time course of 48 hours, which was unlike the 1-week timeframe used in RIFLE (14). The advantages of AKIN have not yet been proven in any comparative studies (17)(18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Validation of the Kidney Disease Improving Global Outcomes Criteria for AKI and Comparison of Three Criteria in Hospitalized Patients

Fujii

Uchino

Takinami

et al. 2014

Clinical Journal of the American Society of Nephrology

138

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Background and objectives AKI is a major clinical problem and predictor of outcome in hospitalized patients. In 2013, the Kidney Disease: Improving Global Outcomes (KDIGO) group published the third consensus AKI definition and classification system after the Risk, Injury, Failure, Loss of Kidney Function, and End-Stage Kidney Disease (RIFLE) and the Acute Kidney Injury Network (AKIN) working group systems. It is unclear which system achieves optimal prognostication in hospital patients.Design, setting, participants, & measurements A retrospective observational study using hospital laboratory, admission, and discharge databases was performed that included adult patients admitted to a teaching hospital in Tokyo, Japan between April 1, 2008, and October 31, 2011. AKI occurring during each hospital stay was identified, and discriminative ability of each AKI classification system based on serum creatinine for the prediction of hospital mortality was assessed. The receiver operating characteristic curve, a graphical measure of test performance, and the area under the curve were used to evaluate how classifications preformed on the study population.Results In total, 49,518 admissions were studied, of which 11.0% were diagnosed with RIFLE criteria and 11.6% were diagnosed with KDIGO criteria, but only 4.8% were diagnosed with AKIN criteria. Overall hospital mortality was 3.0%. AKI staging and hospital mortality were closely correlated in all systems. Discrimination for hospital mortality was similar for RIFLE and KDIGO criteria (area under the curve=0.77 versus 0.78; P=0.02), whereas AKIN discrimination was inferior (area under the curve=0.69 versus RIFLE [P,0.001] versus KDIGO [P,0.001]).Conclusion Among hospital patients, KDIGO and RIFLE criteria achieved similar discrimination, but the discrimination of AKIN was inferior.

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“…II). Wykazano, że kryteria RIFLE i AKIN charakteryzują się porównywalną czułością w definiowaniu klinicznie istotnego WRF [14,15].…”

Section: Zespół Sercowo-nerkowy Typuunclassified

The issue of cardio-renal syndrome and utility of acute kidney injury markers’ assessment in cardiac surgery practice

Krzych¹,

Wybraniec²,

Chudek³

et al. 2012

kitp

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StreszczenieStworzona niedawno klasyfikacja przyczyniła się ostatecznie do ujednolicenia terminologii dotyczącej zespołu sercowo-nerkowego. W ostatnim czasie szczególną uwagę zwrócił typ 1. zespołu sercowo-nerkowego (cardio-renal syndrome type 1 -CRS 1) w związku z udokumentowaniem negatywnego wpływu ostrego uszkodzenia nerek na rokowanie u pacjentów z ostrą dekompensacją układu krążenia, w szczególności u chorych poddawanych operacjom kardiochirurgicznym. Wczesne rozpoznawanie ostrego uszkodzenia nerek (acute kidney injury -AKI) jest ograniczone z powodu stosowania parametrów czynnościowych (zwiększenie stężenia kreatyniny w surowicy). Prowadzone są zatem poszukiwania lepszych wczesnych wyznaczników laboratoryjnych upośledzenia czynności nerek. Największą nadzieję wiąże się z lipokaliną neutrofilową zwią-zaną z żelatynazą (neutrophil gelatinase-associated lipocalin -NGAL), która w licznych badaniach okazała się czułym markerem wystąpienia ostrego zespołu sercowo-nerkowego. Słowa kluczowe: zespół sercowo-nerkowy, ostre uszkodzenie nerek, kardiochirurgia, NGAL, opieka okołooperacyjna. AbstractThe recently established classification of cardio-renal syndrome eventually standardized the nomenclature concerning the interactions between pathology of the heart and kidney. Type 1 cardio-renal syndrome (CRS 1), in which the acute decompensation of the cardiovascular system triggers acute kidney injury (AKI), was found to be associated with poor outcome, especially in the setting of cardiac surgery. Early identification of the onset of AKI is limited on account of the current use of merely functional parameters, such as plasma creatinine concentration. Numerous studies are being performed to identify novel markers of AKI and evaluate their effectiveness. The protein NGAL (neutrophil gelatinase-associated lipocalin) is believed to be a good candidate for a sensitive and early indicator of AKI occurrence.

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Cardiac Surgery-Associated Acute Kidney Injury: A Comparison of Two Consensus Criteria

Cited by 151 publications

References 12 publications

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Validation of the Kidney Disease Improving Global Outcomes Criteria for AKI and Comparison of Three Criteria in Hospitalized Patients

The issue of cardio-renal syndrome and utility of acute kidney injury markers’ assessment in cardiac surgery practice

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