Prognostic Effects of RIFLE Criteria on Mortality and Morbidity in Septic Patients with Acute Kidney Injury

Abstract

ÖZETAmaç: Sepsis ve septik şok sıklıkla akut böbrek hasarı (ABH) ile birlikte seyreder ve kombinasyonunda mortalite %60'a kadar yükselebilir. Bu çalışmada kritik hastalarda ve sepsiste böbrek yetersizliğinin risk (R), böbrek hasarı (I), böbrek fonksiyonunda yetersizlik (F), böbrek fonksiyonun kaybı (L) ve son dönem böbrek yetersizliği (E) (RIFLE) sınıf-landırmasına göre sağkalımı araştırılmıştır. Sonuç: RIFLE sınıflaması hastane içi mortalite ve kısa dönem prognoz ile ilgili olarak yoğun bakımdaki sepsisli hastalarda bir öngörü sağlayabilmektedir.Anahtar kelimeler: Akut böbrek yetersizliği, RİFLE sınıflaması, sağkalım SUMMARY Prognostic Effects of RIFLE Criteria on Mortality and Morbidity in Septic Patients with Acute Kidney InjuryObjective: Sepsis and septic shock are often complicated by acute kidney injury (ABH), and the mortality rates can be as high as 60 % in their combination. This study investigates the outcomes of critically ill and septic patients, and elucidates the association between prognosis and risk of renal failure (R), injury to the kidney (I), failure of the renal function (F), loss of kidney function (L), and end-stage renal failure (E) (RIFLE) classification.Material and Methods: After the approval of ethics committee 1140 patients admitted in our University hospital ICU from January 2007 until December 2007, were retrospectively evaluated. Patients with renal failure or renal transplants were excluded. Clinical, and laboratory parameters related to renal failure, sepsis and survival rates of the patients were evaluated.Results: Among 1031 patients, 15.6 % (n=161) have ABH according to RIFLE classification in the first 24 hours. Patients were classified as those with sepsis 53.41 % (n=86) and without sepsis-ABH 46.59 % (n=75). Although patients with only ABH had a mortality rate of 28 %, patients that have sepsis and ABH; had a mortality rate of 55.8 %. The severity of the disease according to RIFLE classification correlated with Acute Physiology and Chronic Health Evaluation (APACHE II) and sequential organ failure assessment scores.Conclusion: These findings are consistent with a role for RIFLE classification in accurately predicting in-hospital mortality and short-term prognosis in ICU patients with sepsis.