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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Vydáno v:	Kidney international Ročník 73; číslo 5; s. 538 - 546
Hlavní autoři:	Ricci, Z., Cruz, D., Ronco, C.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	New York, NY Elsevier Inc 01.03.2008 Nature Publishing Elsevier Limited
Témata:	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 epidemiology acute renal failure definition RIFLE criteria outcome Kidney disease Nephrology Urinary system disease Prognosis Acute Acute kidney injury Mortality Definition Review Epidemiology Urology Renal failure Bibliographic review
ISSN:	0085-2538, 1523-1755, 1523-1755
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Popis
Shrnutí:	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.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 ObjectType-Review-3 content type line 23 ObjectType-Undefined-4
ISSN:	0085-2538 1523-1755 1523-1755
DOI:	10.1038/sj.ki.5002743