Epidemiology, outcomes and validation of RIFLE and AKIN criteria in acute kidney injury (AKI) in critically ill patients: Indian perspective

Reddy, Pavan K; Ravi, K; Dhanalakshmi, P.; Annigeri, Rajeev A; Ramakrishnan, Nagarajan; Venkataraman, Ramesh

doi:10.3109/0886022x.2014.899432

Cited by 15 publications

(10 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…AKI was based on both creatinine and urine output criteria, but measurement of urine output collection was not specified. The authors found higher incidences of AKI using AKIN compared to RIFLE (46% versus 34%) [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

Incidence, timing and outcome of AKI in critically ill patients varies with the definition used and the addition of urine output criteria

et al. 2017

View full text Add to dashboard Cite

BackgroundAcute kidney injury (AKI) is a serious complication of critical illness with both attributed morbidity and mortality at short-term and long-term. The incidence of AKI reported in critically ill patients varies substantially with the population evaluated and the definitions used. We aimed to assess which of the AKI definitions (RIFLE, AKIN or KDIGO) with or without urine output criteria recognizes AKI most frequently and quickest. Additionally, we conducted a review on the comparison of incidence proportions of varying AKI definitions in populations of critically ill patients.MethodsWe included all patients with index admissions to our intensive care unit (ICU) from January 1st, 2014 until June 11th, 2014 to determine the incidence and onset of AKI by RIFLE, AKIN and KDIGO during the first 7 days of ICU admission. We conducted a sensitive search using PubMed evaluating the comparison of RIFLE, AKIN and KDIGO in critically ill patientsResultsAKI incidence proportions were 15, 21 and 20% respectively using serum creatinine criteria of RIFLE, AKIN and KDIGO. Adding urine output criteria increased AKI incidence proportions to 35, 38 and 38% using RIFLE, AKIN and KDIGO definitions. Urine output criteria detected AKI in patients without AKI at ICU admission in a median of 13 h (IQR 7–22 h; using RIFLE definition) after admission compared to a median of 24 h using serum creatinine criteria (IQR24-48 h). In the literature a large heterogeneity exists in patients included, AKI definition used, reference or baseline serum creatinine used, and whether urine output in the staging of AKI is used.ConclusionAKIN and KDIGO criteria detect more patients with AKI compared to RIFLE criteria. Addition of urine output criteria detect patients with AKI 11 h earlier than serum creatinine criteria and may double AKI incidences in critically ill patients. This could explain the large heterogeneity observed in literature.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-017-0487-8) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

Incidence, timing and outcome of AKI in critically ill patients varies with the definition used and the addition of urine output criteria

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Hospitalizations were adjudicated by investigators who were unaware of the treatment-group assignments and who determined the principal diagnosis and related procedures, whether hospitalization was related to ADPKD, and whether acute kidney injury occurred during hospitalization. Acute kidney injury was defined as an elevation in the serum creatinine level of 0.3 mg per deciliter (30 μmol per liter) or more 29 from the time of hospital admission or from the most recent value obtained at the study site. A discharge diagnosis of acute kidney injury was accepted if no creatinine values were available.…”

Section: Methodsmentioning

confidence: 99%

Blood Pressure in Early Autosomal Dominant Polycystic Kidney Disease

et al. 2014

View full text Add to dashboard Cite

BACKGROUND Hypertension is common in autosomal dominant polycystic kidney disease (ADPKD) and is associated with increased total kidney volume, activation of the renin–angiotensin–aldosterone system, and progression of kidney disease. METHODS In this double-blind, placebo-controlled trial, we randomly assigned 558 hypertensive participants with ADPKD (15 to 49 years of age, with an estimated glomerular filtration rate [GFR] >60 ml per minute per 1.73 m2 of body-surface area) to either a standard blood-pressure target (120/70 to 130/80 mm Hg) or a low blood-pressure target (95/60 to 110/75 mm Hg) and to either an angiotensin-converting–enzyme inhibitor (lisinopril) plus an angiotensin-receptor blocker (telmisartan) or lisinopril plus placebo. The primary outcome was the annual percentage change in the total kidney volume. RESULTS The annual percentage increase in total kidney volume was significantly lower in the low-blood-pressure group than in the standard-blood-pressure group (5.6% vs. 6.6%, P = 0.006), without significant differences between the lisinopril–telmisartan group and the lisinopril–placebo group. The rate of change in estimated GFR was similar in the two medication groups, with a negative slope difference in the short term in the low-blood-pressure group as compared with the standard-blood-pressure group (P<0.001) and a marginally positive slope difference in the long term (P = 0.05). The left-ventricular-mass index decreased more in the low-blood-pressure group than in the standard-blood-pressure group (−1.17 vs. −0.57 g per square meter per year, P<0.001); urinary albumin excretion was reduced by 3.77% with the low-pressure target and increased by 2.43% with the standard target (P<0.001). Dizziness and light-headedness were more common in the low-blood-pressure group than in the standard-blood-pressure group (80.7% vs. 69.4%, P = 0.002). CONCLUSIONS In early ADPKD, the combination of lisinopril and telmisartan did not significantly alter the rate of increase in total kidney volume. As compared with standard blood-pressure control, rigorous blood-pressure control was associated with a slower increase in total kidney volume, no overall change in the estimated GFR, a greater decline in the left-ventricular-mass index, and greater reduction in urinary albumin excretion.

show abstract

“…It is quite clear that there is a linear relationship between stage of AKI and mortality [7,[11][12][13]. The need for dialysis increases the mortality even further, with mortality rates between 45 and 65% [11,12,14].…”

Section: Predictors Of Outcomesmentioning

confidence: 99%