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North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): targeting the problem with the RIFLE Criteria.
Clin J Am Soc Nephrol. 2007 May; 2(3):418-25.CJ

Abstract

Acute kidney injury (AKI) in the intensive care unit (ICU) is associated with an enhanced mortality. The Acute Dialysis Quality Initiative group has proposed the RIFLE (Risk-Injury-Failure-Loss-ESRD) classification to standardize the approach to AKI. This study was performed to estimate the AKI incidence in ICU patients in northeastern Italy and describe clinical characteristics and outcomes of patients with AKI on the basis of their RIFLE class. A prospective multicenter observational study was performed of patients who fulfilled AKI criteria in 19 ICU in northeastern Italy. Data were analyzed using multivariate logistic regression and survival curve analysis. Of 2164 ICU patients who were admitted during the study period, 234 (10.8%; 95% confidence interval 9.5 to 12.1%) developed AKI; 19% were classified as risk (R), 35% as injury (I), and 46% as failure (F). Preexisting kidney disease was present in 36.8%. The most common causes of AKI were prerenal causes (38.9%) and sepsis (25.6%). At diagnosis of AKI, median serum creatinine and urine output were 2.0 mg/dl and 1100 ml/d, respectively. ICU mortality was 49.5% in class F, 29.3% in I, and 20% in R. Independent risk factors for mortality included RIFLE class, sepsis, and need for renal replacement therapy, whereas a postsurgical cause of AKI, exposure to nephrotoxins, higher serum creatinine, and urine output were associated with lower mortality risk. In this study, AKI incidence in the ICU was between 9 and 12%, with 3.3% of ICU patients requiring renal replacement therapy. Sepsis was a significant contributing factor. Overall mortality was between 30 and 42%, and was highest among those in RIFLE class F.

Authors+Show Affiliations

Department of Nephrology and Intensive Care, San Bortolo Hospital, Vicenza, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17699446

Citation

Cruz, Dinna N., et al. "North East Italian Prospective Hospital Renal Outcome Survey On Acute Kidney Injury (NEiPHROS-AKI): Targeting the Problem With the RIFLE Criteria." Clinical Journal of the American Society of Nephrology : CJASN, vol. 2, no. 3, 2007, pp. 418-25.
Cruz DN, Bolgan I, Perazella MA, et al. North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): targeting the problem with the RIFLE Criteria. Clin J Am Soc Nephrol. 2007;2(3):418-25.
Cruz, D. N., Bolgan, I., Perazella, M. A., Bonello, M., de Cal, M., Corradi, V., Polanco, N., Ocampo, C., Nalesso, F., Piccinni, P., & Ronco, C. (2007). North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): targeting the problem with the RIFLE Criteria. Clinical Journal of the American Society of Nephrology : CJASN, 2(3), 418-25.
Cruz DN, et al. North East Italian Prospective Hospital Renal Outcome Survey On Acute Kidney Injury (NEiPHROS-AKI): Targeting the Problem With the RIFLE Criteria. Clin J Am Soc Nephrol. 2007;2(3):418-25. PubMed PMID: 17699446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): targeting the problem with the RIFLE Criteria. AU - Cruz,Dinna N, AU - Bolgan,Irene, AU - Perazella,Mark A, AU - Bonello,Monica, AU - de Cal,Massimo, AU - Corradi,Valentina, AU - Polanco,Natalia, AU - Ocampo,Catalina, AU - Nalesso,Federico, AU - Piccinni,Pasquale, AU - Ronco,Claudio, AU - ,, Y1 - 2007/03/27/ PY - 2007/8/19/pubmed PY - 2007/9/29/medline PY - 2007/8/19/entrez SP - 418 EP - 25 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 2 IS - 3 N2 - Acute kidney injury (AKI) in the intensive care unit (ICU) is associated with an enhanced mortality. The Acute Dialysis Quality Initiative group has proposed the RIFLE (Risk-Injury-Failure-Loss-ESRD) classification to standardize the approach to AKI. This study was performed to estimate the AKI incidence in ICU patients in northeastern Italy and describe clinical characteristics and outcomes of patients with AKI on the basis of their RIFLE class. A prospective multicenter observational study was performed of patients who fulfilled AKI criteria in 19 ICU in northeastern Italy. Data were analyzed using multivariate logistic regression and survival curve analysis. Of 2164 ICU patients who were admitted during the study period, 234 (10.8%; 95% confidence interval 9.5 to 12.1%) developed AKI; 19% were classified as risk (R), 35% as injury (I), and 46% as failure (F). Preexisting kidney disease was present in 36.8%. The most common causes of AKI were prerenal causes (38.9%) and sepsis (25.6%). At diagnosis of AKI, median serum creatinine and urine output were 2.0 mg/dl and 1100 ml/d, respectively. ICU mortality was 49.5% in class F, 29.3% in I, and 20% in R. Independent risk factors for mortality included RIFLE class, sepsis, and need for renal replacement therapy, whereas a postsurgical cause of AKI, exposure to nephrotoxins, higher serum creatinine, and urine output were associated with lower mortality risk. In this study, AKI incidence in the ICU was between 9 and 12%, with 3.3% of ICU patients requiring renal replacement therapy. Sepsis was a significant contributing factor. Overall mortality was between 30 and 42%, and was highest among those in RIFLE class F. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/17699446/North_East_Italian_Prospective_Hospital_Renal_Outcome_Survey_on_Acute_Kidney_Injury__NEiPHROS_AKI_:_targeting_the_problem_with_the_RIFLE_Criteria_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=17699446 DB - PRIME DP - Unbound Medicine ER -