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A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients.
Nephrol Dial Transplant. 2008 Apr; 23(4):1203-10.ND

Abstract

BACKGROUND

The Acute Dialysis Quality Initiative Working Group recently developed the RIFLE criteria, a consensus definition for acute kidney injury (AKI). We sought to evaluate the RIFLE criteria on the day of ICU admission in a large heterogenous population of critically ill patients.

METHODS

Retrospective interrogation of prospectively collected data from the Australian New Zealand Intensive Care Society Adult Patient Database. We evaluated 120 123 patients admitted for >/=24 h from 1 January 2000 to 31 December 2005 from 57 ICUs across Australia.

RESULTS

The median (IQR) age was 64.3 (50.8-75.4) years, 59.5% were male, 28.6% had co-morbid disease, 50.3% were medical admissions and the initial mean (+/-SD) APACHEII score was 16.9 (+/-7.7). According to the RIFLE criteria, on the day of admission, AKI occurred in 36.1%, with a maximum RIFLE category of Risk in 16.3%, Injury in 13.6%, and Failure 6.3%. AKI, defined by any RIFLE category, was associated with an increase in hospital mortality (OR 3.29, 95% CI 3.19-3.41, P < 0.0001). The crude hospital mortality stratified by RIFLE category was 17.9% for Risk, 27.7% for Injury and 33.2% for Failure. By multivariable analysis, each RIFLE category was independently associated with hospital mortality (OR: Risk 1.58, Injury 2.54 and Failure 3.22).

CONCLUSION

In a large heterogenous cohort of critically ill patients, the RIFLE criteria classified >36% with AKI on the day of admission. For successive increases in severity of RIFLE category, there were increases in hospital mortality. The RIFLE criteria represent a simple tool for the detection and classification of AKI and for correlation with clinical outcomes.

Authors+Show Affiliations

Division of Critical Care Medicine, University of Alberta Hospital, 3C1.16 Walter C. Mackenzie Centre, 8440-122 Street, Edmonton, Alberta T6G2B7, Canada. bagshaw@ualberta.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

17962378

Citation

Bagshaw, Sean M., et al. "A Multi-centre Evaluation of the RIFLE Criteria for Early Acute Kidney Injury in Critically Ill Patients." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 23, no. 4, 2008, pp. 1203-10.
Bagshaw SM, George C, Dinu I, et al. A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant. 2008;23(4):1203-10.
Bagshaw, S. M., George, C., Dinu, I., & Bellomo, R. (2008). A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 23(4), 1203-10.
Bagshaw SM, et al. A Multi-centre Evaluation of the RIFLE Criteria for Early Acute Kidney Injury in Critically Ill Patients. Nephrol Dial Transplant. 2008;23(4):1203-10. PubMed PMID: 17962378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. AU - Bagshaw,Sean M, AU - George,Carol, AU - Dinu,Irina, AU - Bellomo,Rinaldo, Y1 - 2007/10/25/ PY - 2007/10/27/pubmed PY - 2008/5/2/medline PY - 2007/10/27/entrez SP - 1203 EP - 10 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 23 IS - 4 N2 - BACKGROUND: The Acute Dialysis Quality Initiative Working Group recently developed the RIFLE criteria, a consensus definition for acute kidney injury (AKI). We sought to evaluate the RIFLE criteria on the day of ICU admission in a large heterogenous population of critically ill patients. METHODS: Retrospective interrogation of prospectively collected data from the Australian New Zealand Intensive Care Society Adult Patient Database. We evaluated 120 123 patients admitted for >/=24 h from 1 January 2000 to 31 December 2005 from 57 ICUs across Australia. RESULTS: The median (IQR) age was 64.3 (50.8-75.4) years, 59.5% were male, 28.6% had co-morbid disease, 50.3% were medical admissions and the initial mean (+/-SD) APACHEII score was 16.9 (+/-7.7). According to the RIFLE criteria, on the day of admission, AKI occurred in 36.1%, with a maximum RIFLE category of Risk in 16.3%, Injury in 13.6%, and Failure 6.3%. AKI, defined by any RIFLE category, was associated with an increase in hospital mortality (OR 3.29, 95% CI 3.19-3.41, P < 0.0001). The crude hospital mortality stratified by RIFLE category was 17.9% for Risk, 27.7% for Injury and 33.2% for Failure. By multivariable analysis, each RIFLE category was independently associated with hospital mortality (OR: Risk 1.58, Injury 2.54 and Failure 3.22). CONCLUSION: In a large heterogenous cohort of critically ill patients, the RIFLE criteria classified >36% with AKI on the day of admission. For successive increases in severity of RIFLE category, there were increases in hospital mortality. The RIFLE criteria represent a simple tool for the detection and classification of AKI and for correlation with clinical outcomes. SN - 1460-2385 UR - https://www.unboundmedicine.com/medline/citation/17962378/A_multi_centre_evaluation_of_the_RIFLE_criteria_for_early_acute_kidney_injury_in_critically_ill_patients_ L2 - https://academic.oup.com/ndt/article-lookup/doi/10.1093/ndt/gfm744 DB - PRIME DP - Unbound Medicine ER -