RIFLE Classification: prospective analysis of the association with mortality in critical ill patiants

Wahrhaftig, Katia de Macedo; Correia, Luís Cláudio Lemos; Souza, Carlos Alfredo Marcílio de

doi:10.5935/0101-2800.20120027

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…The SOFA score was reported in 21 and 10 studies from developed and developing countries, respectively. The distribution of the SOFA score was similar between groups, ranging from 3 [25] to 13.4 [26] in studies from developed countries and from 3 [27] to 9.8 [28] in developing country studies. In studies where this information was available, a SOFA score over 5 was reported by 71% (15/21) of studies from developed countries and 80% (8/10) of studies in developing countries (Tables 6 and 7).…”

Section: Patient Characteristicsmentioning

confidence: 99%

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

et al. 2020

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Objectives Although the majority of the global population lives in developing countries, most of the epidemiological data related to intensive care unit (ICU) acute kidney injury (AKI) comes from developed countries. This systematic review aims to ascertain the methodology of studies on ICU AKI patients in developing and developed countries, to determine whether epidemiological comparisons between these two settings are possible, and to present a summary estimate of AKI incidence. Methods A systematic review of published studies reporting AKI in intensive care units (2005-2015) identified in PubMed, LILACS, and IBECs databases was conducted. We compared developed and developing countries by evaluating study methodology, AKI reference serum creatinine definitions, population characteristics, AKI incidence and mortality. AKI incidence was calculated with a random-effects model. Results Ninety-two studies were included, one of which reported data from both country categories: 60 from developed countries (1,057,332 patients) and 33 from developing countries (34,539 patients). In 78% of the studies, AKI was defined by the RIFLE, AKIN or KDIGO criteria. Oliguria had 11 different definitions and reference creatinine 23 different values. For the metaanalysis, 38 studies from developed and 18 from developing countries were selected, with similar AKI incidence: 39.3% and 35.1%, respectively. The need for dialysis, length of ICU stay and mortality were higher in developing countries.

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Section: Patient Characteristicsmentioning

confidence: 99%

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

et al. 2020

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“…Two studies found incidences of 25.5% ( Ponce et al., 2011 ) and 39.3% ( Nisula et al., 2013 ) using AKIN classification. Other authors reported an incidence range of 35.7–47.0% by using the Risk/Injury/Failure/Loss/End-stage (RIFLE) system ( Bagshaw et al., 2008 ; Wahrhaftig, Correia & De Souza, 2012 ; Mohamed et al., 2013 ). In a prospective study including 29,269 patients hospitalized at 54 ICUs from 23 countries, Uchino et al.…”

Section: Discussionmentioning

confidence: 99%

“…Bivariate analysis highlighted the relevant risk factors for AKI that have been investigated individually or in combination by other observational studies ( Mataloun et al., 2006 ; Prakash et al., 2006 ; Taber & Mueller, 2006 ; Bagshaw et al., 2008 ; Perazella, 2012 ; Wahrhaftig, Correia & De Souza, 2012 ; Wang et al., 2012 ; Herrera-Gutiérrez et al., 2013 ; Mohamed et al., 2013 ). We found that typical risk factors were associated with AKI in the studied patients, including advanced age, higher APACHE II score at admission to ICU, sedation, mechanical ventilation, and infection.…”

Section: Discussionmentioning

confidence: 99%

Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study

Soares

Mambrini

Botelho

et al. 2018

PeerJ

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BackgroundAcute kidney injury (AKI) is associated with a significant increase in morbidity, mortality, and health care costs. In intensive care units (ICU), AKI is commonly multifactorial and frequently involves diverse factors, such as hypovolemia, sepsis, and the use of nephrotoxic drugs. We aimed to investigate drug therapy and other factors associated with the development of AKI in a Brazilian public hospital.MethodsThis is a cross-sectional study involving critically ill patients at an ICU of a tertiary hospital. All data on sequential serum creatinine (SCr) level, glomerular filtration rate (GFR), and urine output were collected during ICU stay. The primary outcome was the occurrence of AKI assessed by the Acute Kidney Injury Network (AKIN) criterion. Sociodemographics, clinical data and drug therapy were considered as covariates. Factors associated with AKI were assessed using logistic regression.ResultsOverall, 122 participants were included in the study. Median age was 46.0 (interquartile range, IQ = 29.0–69.0) years, with a predominance of men (58.2%). Mean number of prescribed drugs throughout ICU stay was 22.0 ± 9.4. The number of potentially nephrotoxic drugs ranged from two to 24 per patient. A total of 29 (23.8%) ICU patients developed AKI. In the AKI-group, patients were older and showed higher Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at admission, higher rates of sedation, mechanical ventilation, and infection. More drugs in general and specifically more vasoactive drugs were prescribed for AKI group. Patients who developed AKI tended to have extended stays in the ICU and a lower probability of being discharged alive than patients with no AKI development. Model adjustments of logistic regression showed that the number of medications (OR 1.15; 95% CI [1.05–1.27]) was the only factor associated with AKI in this study. This association was independent of drug nephrotoxicity.DiscussionIntensive care is characterized by its complexity that combines unstable patients, severe diseases, high density of medical interventions, and drug use. We found that typical risk factors for AKI showed statistical association on bivariate analysis. The contribution of drug therapy in the occurrence of AKI in medical ICUs reinforces the need for prevention strategies focused on early recognition of renal dysfunction and interventions in drug therapy. These actions would help improve the quality of patient care and ensure progress towards medication safety.

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“…GFR-and serum creatinine measurements and definition of acute kidney injury GFR (MDRD (modification of diet in renal disease) formula) and serum creatinine were measured in all patients before TAVI (b2 days) and after TAVI at the day of the procedure and then continuously until discharge (mean hospital stay was 16.8 ± 12.2 days). The occurrence of AKI during hospitalization was defined according to the Rifle classification [16]. In this classification, AKI is defined as a decrease of GFR by more than 50% or a 2 fold increase in serum-creatinine.…”

Section: Patientsmentioning

confidence: 99%

Impact of kidney function on mortality after transcatheter valve implantation in patients with severe aortic valvular stenosis

Voigtländer¹,

Schewel²,

Martin³

et al. 2015

International Journal of Cardiology

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RIFLE Classification: prospective analysis of the association with mortality in critical ill patiants

Cited by 5 publications

References 21 publications

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

A systematic review and meta-analysis of acute kidney injury in the intensive care units of developed and developing countries

Drug therapy and other factors associated with the development of acute kidney injury in critically ill patients: a cross-sectional study

Impact of kidney function on mortality after transcatheter valve implantation in patients with severe aortic valvular stenosis

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