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Acute kidney injury in intensive care units according to RIFLE classification: a population-based study
M I Sigurdsson1, I O Vesteinsdottir, K Sigvaldason
1Department of Anaesthesia & Intensive Care Medicine, Landspitali University Hospital, Reykjavik, Iceland.
Acta Anaesthesiologica Scandinavica
|September 25, 2012
Summary
Acute kidney injury (AKI) incidence in intensive care units (ICUs) was 21.7% using measured creatinine. Estimated creatinine overestimated AKI, and survivors had low end-stage renal failure rates.
Area of Science:
- Nephrology
- Intensive Care Medicine
- Epidemiology
Background:
- Previous acute kidney injury (AKI) incidence studies relied on estimated creatinine.
- Accurate AKI incidence determination is crucial for intensive care unit (ICU) patient management.
Purpose of the Study:
- To accurately determine the incidence of AKI in a whole ICU population using the RIFLE criteria.
- To compare AKI incidence using measured versus estimated baseline creatinine.
Main Methods:
- Retrospective analysis of 1026 adult ICU patients at a national university hospital.
- Meticulous search for measured baseline creatinine values.
- Application of RIFLE criteria to classify AKI severity.
Main Results:
- The incidence of AKI was 21.7%, with specific rates for Risk (7.1%), Injury (6.8%), and Failure (7.8%) subgroups.
- Estimated baseline creatinine overestimated AKI incidence by 3.5%.
- One-year survival for AKI patients was 51%, with only 2.5% requiring chronic renal replacement therapy after 90 days.
Conclusions:
- The actual incidence of AKI in ICUs may be lower than previously reported.
- Accurate baseline creatinine measurement is vital for correct AKI diagnosis.
- AKI patients face high mortality, but long-term renal failure is uncommon in survivors.
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