The RIFLE criteria and mortality in acute kidney injury: A systematic review
In 2004, the Acute Dialysis Quality Initiative workgroup proposed a multilevel classification system for acute kidney injury (AKI) identified by the acronym RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease). Several studies have been published aiming to validate an...
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| Vydané v: | Kidney international Ročník 73; číslo 5; s. 538 - 546 |
|---|---|
| Hlavní autori: | , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
New York, NY
Elsevier Inc
01.03.2008
Nature Publishing Elsevier Limited |
| Predmet: | |
| ISSN: | 0085-2538, 1523-1755, 1523-1755 |
| On-line prístup: | Získať plný text |
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| Abstract | In 2004, the Acute Dialysis Quality Initiative workgroup proposed a multilevel classification system for acute kidney injury (AKI) identified by the acronym RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease). Several studies have been published aiming to validate and apply it in clinical practice, verifying whether outcome progressively worsened with the severity of AKI. A literature search from August 2004 to June 2007 was conducted: 24 studies in which the RIFLE classification was used to define AKI were identified. In 13 studies, patient-level data on mortality were available for Risk, Injury, and Failure patients, as well as those without AKI (non-AKI). Death was reported at ICU discharge, hospital discharge, 28, 30, 60, and 90 days. The pooled estimate of relative risk (RR) for mortality for patients with R, I, or F levels compared with non-AKI patients were analyzed. Over 71 000 patients were included in the analysis of published reports. With respect to non-AKI, there appeared to be a stepwise increase in RR for death going from Risk (RR=2.40) to Injury (RR=4.15) to Failure (6.37, P<0.0001 for all). There was significant intertrial heterogeneity as expected with the varying patient populations studied. The RIFLE classification is a simple, readily available clinical tool to classify AKI in different populations. It seems to be a good outcome predictor, with a progressive increase in mortality with worsening RIFLE class. It also suggests that even mild degrees of kidney dysfunction may have a negative impact on outcome. Further refinement of RIFLE nomenclature and classification is ongoing. |
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| AbstractList | In 2004, the Acute Dialysis Quality Initiative workgroup proposed a multilevel classification system for acute kidney injury (AKI) identified by the acronym RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease). Several studies have been published aiming to validate and apply it in clinical practice, verifying whether outcome progressively worsened with the severity of AKI. A literature search from August 2004 to June 2007 was conducted: 24 studies in which the RIFLE classification was used to define AKI were identified. In 13 studies, patient-level data on mortality were available for Risk, Injury, and Failure patients, as well as those without AKI (non-AKI). Death was reported at ICU discharge, hospital discharge, 28, 30, 60, and 90 days. The pooled estimate of relative risk (RR) for mortality for patients with R, I, or F levels compared with non-AKI patients were analyzed. Over 71 000 patients were included in the analysis of published reports. With respect to non-AKI, there appeared to be a stepwise increase in RR for death going from Risk (RR=2.40) to Injury (RR=4.15) to Failure (6.37, P<0.0001 for all). There was significant intertrial heterogeneity as expected with the varying patient populations studied. The RIFLE classification is a simple, readily available clinical tool to classify AKI in different populations. It seems to be a good outcome predictor, with a progressive increase in mortality with worsening RIFLE class. It also suggests that even mild degrees of kidney dysfunction may have a negative impact on outcome. Further refinement of RIFLE nomenclature and classification is ongoing. In 2004, the Acute Dialysis Quality Initiative workgroup proposed a multilevel classification system for acute kidney injury (AKI) identified by the acronym RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease). Several studies have been published aiming to validate and apply it in clinical practice, verifying whether outcome progressively worsened with the severity of AKI. A literature search from August 2004 to June 2007 was conducted: 24 studies in which the RIFLE classification was used to define AKI were identified. In 13 studies, patient-level data on mortality were available for Risk, Injury, and Failure patients, as well as those without AKI (non-AKI). Death was reported at ICU discharge, hospital discharge, 28, 30, 60, and 90 days. The pooled estimate of relative risk (RR) for mortality for patients with R, I, or F levels compared with non-AKI patients were analyzed. Over 71 000 patients were included in the analysis of published reports. With respect to non-AKI, there appeared to be a stepwise increase in RR for death going from Risk (RR=2.40) to Injury (RR=4.15) to Failure (6.37, P<0.0001 for all). There was significant intertrial heterogeneity as expected with the varying patient populations studied. The RIFLE classification is a simple, readily available clinical tool to classify AKI in different populations. It seems to be a good outcome predictor, with a progressive increase in mortality with worsening RIFLE class. It also suggests that even mild degrees of kidney dysfunction may have a negative impact on outcome. Further refinement of RIFLE nomenclature and classification is ongoing.In 2004, the Acute Dialysis Quality Initiative workgroup proposed a multilevel classification system for acute kidney injury (AKI) identified by the acronym RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease). Several studies have been published aiming to validate and apply it in clinical practice, verifying whether outcome progressively worsened with the severity of AKI. A literature search from August 2004 to June 2007 was conducted: 24 studies in which the RIFLE classification was used to define AKI were identified. In 13 studies, patient-level data on mortality were available for Risk, Injury, and Failure patients, as well as those without AKI (non-AKI). Death was reported at ICU discharge, hospital discharge, 28, 30, 60, and 90 days. The pooled estimate of relative risk (RR) for mortality for patients with R, I, or F levels compared with non-AKI patients were analyzed. Over 71 000 patients were included in the analysis of published reports. With respect to non-AKI, there appeared to be a stepwise increase in RR for death going from Risk (RR=2.40) to Injury (RR=4.15) to Failure (6.37, P<0.0001 for all). There was significant intertrial heterogeneity as expected with the varying patient populations studied. The RIFLE classification is a simple, readily available clinical tool to classify AKI in different populations. It seems to be a good outcome predictor, with a progressive increase in mortality with worsening RIFLE class. It also suggests that even mild degrees of kidney dysfunction may have a negative impact on outcome. Further refinement of RIFLE nomenclature and classification is ongoing. |
| Author | Ricci, Z. Cruz, D. Ronco, C. |
| Author_xml | – sequence: 1 givenname: Z. surname: Ricci fullname: Ricci, Z. email: z.ricci@libero.it organization: Department of Pediatric Cardiosurgery, Bambino Gesù Hospital, Rome, Italy – sequence: 2 givenname: D. surname: Cruz fullname: Cruz, D. organization: Department of Nephrology, Dialysis and Transplantation, S Bortolo Hospital, Vicenza, Italy – sequence: 3 givenname: C. surname: Ronco fullname: Ronco, C. organization: Department of Nephrology, Dialysis and Transplantation, S Bortolo Hospital, Vicenza, Italy |
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| SubjectTerms | Acute Disease acute renal failure definition Biological and medical sciences epidemiology Female Humans Italy - epidemiology Kidney Diseases - complications Kidney Diseases - diagnosis Kidney Diseases - mortality Kidney Failure, Chronic - classification Kidney Failure, Chronic - diagnosis Kidney Failure, Chronic - mortality Kidneys Male Medical sciences Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure outcome Prognosis Renal failure RIFLE criteria Severity of Illness Index Urinary system involvement in other diseases. Miscellaneous |
| Title | The RIFLE criteria and mortality in acute kidney injury: A systematic review |
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