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RIFLE Classification

Paolo Angeli, Dimitri Bezinover, Gianni Biancofiore, Anja Bienholz, James Findlay, Catherine Paugam Burtz, Koen Reyntjens, Tetsuro Sakai, Fuat H Saner, Dana Tomescu, Gebhard Wagener, Emmanuel Weiss
Acute kidney injury (AKI) is associated with high perioperative mortality. A series of AKI research breakthroughs are worth mentioning. First, in 2003, serum and urine biomarkers specific to AKI were identified. These biomarkers have contributed to early detection, prevention, and treatment of AKI. In 2004, AKI severity was defined with the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, which was developed by the International Consensus Conference Workgroup of the Acute Dialysis Quality Initiative...
October 19, 2016: Minerva Anestesiologica
Akihiro Shirakabe, Nobuaki Kobayashi, Noritake Hata, Takuro Shinada, Kazunori Tomita, Masafumi Tsurumi, Hirotake Okazaki, Masato Matsushita, Yoshiya Yamamoto, Shinya Yokoyama, Kuniya Asai, Wataru Shimizu
BACKGROUND: No cardiac biomarkers for detecting acute kidney injury (AKI) on admission in non-surgical intensive care patients have been reported. The aim of the present study is to elucidate the role of cardiac biomarkers for quickly identifying the presence of AKI on admission. METHODS: Data for 1183 patients who underwent the measurement of cardiac biomarkers, including the serum heart-type fatty acid-binding protein (s-HFABP) level, in the emergency department were screened, and 494 non-surgical intensive care patients were enrolled in this study...
September 5, 2016: BMC Cardiovascular Disorders
H A Erdost, S Ozkardesler, M Akan, L Iyilikci, T Unek, E Ocmen, R M Dalak, I Astarcioglu
BACKGROUND: The aim of this study was to determine the incidence and peri-operative risk factors for acute renal injury (ARI) and their relationship with mortality rate through the use of 3 different ARI diagnostic classifications in patients after liver transplantation (LT). METHODS: We retrospectively investigated the medical records of adult LT recipients. Post-operative ARI was determined with the Risk, Injury, Failure, Loss, and End-Stage Renal Failure (RIFLE), Acute Kidney Injury Network (AKIN), and Kidney Disease: Improving Global Outcomes (KDIGO) classifications...
July 2016: Transplantation Proceedings
Kady Phe, Ryan K Shields, Frank P Tverdek, Samuel L Aitken, David J Guervil, Wai-Ying M Lam, Rachel J Musgrove, Andrea M Luce, Vincent H Tam
OBJECTIVES: With increasing rates of infections caused by MDR Gram-negative organisms, clinicians resort to older agents such as colistimethate sodium (CMS) despite a significant risk of nephrotoxicity. Several risk factors for CMS-associated nephrotoxicity have been reported, but they have yet to be validated. We compared the performance of published mathematical models in predicting the risk of CMS-associated nephrotoxicity. METHODS: In a multicentre, retrospective, cohort study, adult patients (≥18 years of age) were evaluated from five large academic medical centres in the USA...
August 19, 2016: Journal of Antimicrobial Chemotherapy
Alexandru Rocşoreanu, Daniela Cernea, Cristiana Eugenia Simionescu, Eugen MoŢa
Bleeding disorders, associated with macroscopic and microscopic lesions in different organs are frequently found in acute kidney injury (AKI), in the third stage of the RIFLE (risk, injury, failure, loss, end-stage kidney disease) classification, treated by hemodialysis. The study included 81 cases of AKI of various causes (septic, posttraumatic, postoperative, toxic, medical nephropathies). 59.25% of the patients presented various forms of bleeding disorders (gastrointestinal bleeding, meningo-cerebral hemorrhage, epistaxis, hemodialysis vascular access bleeding, etc...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Ivo W Soliman, Jos F Frencken, Linda M Peelen, Arjen J C Slooter, Olaf L Cremer, Johannes J van Delden, Diederik van Dijk, Dylan W de Lange
BACKGROUND: Prognostic factors for the combination of long-term survival and health-related quality of life (HRQoL) after intensive care unit (ICU) stay have not yet been studied. Our aim was to assess whether early acute kidney injury (eAKI), AKI occurring on the first day of ICU admission, is an independent predictor of this combined one-year outcome. METHODS: We included all patients admitted to the mixed ICU of the University Medical Centre Utrecht between July 2009 and April 2013, excluding patients with chronic dialysis, cardiac surgery, and length of stay shorter than 24 hours...
2016: Critical Care: the Official Journal of the Critical Care Forum
Richard K D Ephraim, Kwame O Darkwah, Samuel A Sakyi, Mabel Ephraim, Enoch O Antoh, Prince Adoba
BACKGROUND: Acute kidney injury (AKI) affects 3-7 % of patients admitted to the hospital and approximately 25-30 % of patients in the intensive care unit. RIFLE, a newly developed international consensus classification for AKI, defines three grades of severity-class R (risk), I (injury) and F (failure). The aim of this study was to evaluate whether the RIFLE system of classification can detect the incidence of AKI using retrospective data of in-patients at the Effia-Nkwanta Regional Hospital...
2016: BMC Nephrology
Reza Hekmat, Mahmood Mohebi
To evaluate the kidney function after living kidney donation, we measured serum creatinine (SCr), cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL) of 42 living donors before uninephrectomy and in three immediate days after it. We also evaluated the prevalence of the occurrence of the different stages of acute kidney injury (AKI) classified according to risk, injury, failure, loss, and end-stage (RIFLE) criteria, and accuracy of each of these three biomarkers for predicting them were evaluated...
July 2016: Saudi Journal of Kidney Diseases and Transplantation
Sara Korula, Sindhu Balakrishnan, Shyam Sundar, Vergis Paul, Anuroop Balagopal
BACKGROUND AND AIMS: The information regarding the incidence of acute kidney injury (AKI) in medical Intensive Care Units (ICUs) in South India is limited. The aim of the study was to find the incidence, prognostic factors, and outcome of patients with AKI. We also assessed whether only urine output criteria of risk, injury, failure, loss, end (RIFLE) classification can be used to look at the outcome of AKI. PATIENTS AND METHODS: This was a prospective, cross-sectional study of 6 months duration in a 28 bedded medical ICU of a tertiary center...
June 2016: Indian Journal of Critical Care Medicine
G Seller-Pérez, S Más-Font, C Pérez-Calvo, P Villa-Díaz, M Celaya-López, M E Herrera-Gutiérrez
Acute kidney injury (AKI) in the ICU frequently requires costly supportive therapies, has high morbidity, and its long-term prognosis is not as good as it has been presumed so far. Consequently, AKI generates a significant burden for the healthcare system. The problem is that AKI lacks an effective treatment and the best approach relies on early secondary prevention. Therefore, to facilitate early diagnosis, a broader definition of AKI should be established, and a marker with more sensitivity and early-detection capacity than serum creatinine - the most common marker of AKI - should be identified...
August 2016: Medicina Intensiva
Claudio Ronco
The RIFLE classification was introduced in 2004 to describe the presence of acute kidney injury (AKI) and to define its clinical stage, based upon the serum creatinine level and urine output. The same criteria, although slightly modified, are used in the other scoring systems AKIN and KDIGO. Mortality and morbidity remain high in AKI, suggesting that current diagnostic methods are suboptimal, poorly accurate, and often timely inadequate in detecting the presence of early kidney injury. Conversely, a growing body of evidence indicates that new AKI biomarkers can be used to both rule out AKI and to assess high-risk conditions or the presence of subclinical forms...
2016: Critical Care: the Official Journal of the Critical Care Forum
Atike Tekeli Kunt, Hakan Parlar, Orhan Findik, Cagri Duzyol, Ozgur Baris, Canan Balci
BACKGROUND: Metabolic syndrome (MetS) is defined as a cluster of systemic abnormalities: hyperglycemia, dyslipidemia, abdominal obesity, and hypertension. Acute kidney injury (AKI) is one of the devastating complications after cardiac surgery. Age, DM, preexisting renal dysfunction, hypertension, impaired left ventricular function, and severe arteriosclerosis of the aorta are the major risk factors for the development of AKI. The purpose of the current study was to analyze the influence of MetS on AKI occurring after coronary artery bypass grafting (CABG)...
2016: Heart Surgery Forum
George J Arnaoutakis, Prashanth Vallabhajosyula, Joseph E Bavaria, Ibrahim Sultan, Mary Siki, Suveeksha Naidu, Rita K Milewski, Matthew L Williams, W Clark Hargrove, Nimesh D Desai, Wilson Y Szeto
BACKGROUND: There remains concern that moderate hypothermic circulatory arrest (MHCA) with antegrade cerebral perfusion (ACP) may provide suboptimal distal organ protection compared with deep hypothermic circulatory arrest (DHCA) with retrograde cerebral perfusion (RCP). We compared postoperative acute kidney injury (AKI) in in patients who underwent elective hemiarch repair with either DHCA/RCP or MHCA/ACP. METHODS: This was a retrospective review of all patients undergoing elective aortic hemiarch reconstruction for aneurysmal disease between 2009 and 2014...
October 2016: Annals of Thoracic Surgery
Yosuke Toyonaga, Mutsuhito Kikura
AIM: Hyperchloremic acidosis may have an important role as a precursor of acute kidney injury (AKI) in the hyperchloremic environment induced by chloride-rich fluids, but this remains unclear. We tested the hypothesis that hyperchloremic acidosis assessed by the Stewart approach is associated with postoperative AKI. METHODS: A historical cohort study was conducted in adult patients who had normal renal function preoperatively and required admission to the intensive care unit after elective abdominal surgery...
June 16, 2016: Nephrology
Emilio Rodrigo, Borja Suberviola, Zoila Albines, Álvaro Castellanos, Milagros Heras, Juan Carlos Rodriguez-Borregán, Celestino Piñera, Mara Serrano, Manuel Arias
BACKGROUND: Since 2004, various criteria have been proposed to define and stage acute kidney injury (AKI). Nevertheless, fixed criteria for assessing severe sepsis-related AKI have not yet been established. OBJECTIVES: To assess the ability of the different AKI classification methods to predict mortality in a cohort of patients with sepsis. METHODS: A prospective study of patients>18 years with septic shock admitted to the intensive care unit (ICU) of our hospital from April 2008 to September 2010 was conducted...
June 10, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Teresa Chuva, José Maximino, Joselina Barbosa, Sandra Silva, Ana Paiva, Jorge Baldaia, Alfredo Loureiro
BACKGROUND: Acute kidney injury (AKI) often complicates the course of haematological malignancies (HMs) and confers a worse prognosis. The majority of these patients are managed by the attending physician, yet, a small group, mostly coincident with the worst presentation and outcomes, requires nephrology consultation, challenging the clinician with ethical issues regarding the decision to initiate or forgo renal support therapy. The purpose of this work is to identify the prognostic determinants for in-hospital mortality in this population...
June 2016: Clinical Kidney Journal
Chien-Ning Hsu, Chien-Te Lee, Chien-Hao Su, Yu-Ching Lily Wang, Hsiao-Ling Chen, Jiin-Haur Chuang, You-Lin Tain
The disease burden and outcomes of community-acquired (CA-) and hospital-acquired acute kidney injury (HA-AKI) are not well understood. The aim of the study was to investigate the incidence, outcomes, and risk factors of AKI in a large Taiwanese adult cohort.This retrospective cohort study examined 734,340 hospital admissions from a group of hospitals within an organization in Taiwan between January 1, 2010 and December 31, 2014. Patients with AKI at discharge were classified as either CA- or HA-AKI based on the RIFLE (risk, injury, failure, loss of function, end stage of kidney disease) classification criteria...
May 2016: Medicine (Baltimore)
Richard F Newland, Robert A Baker, Annette L Mazzone, Steven S Quinn, Derek P Chew
BACKGROUND: Acute kidney injury (AKI) after cardiopulmonary bypass (CPB) is associated with a requirement for dialysis, a longer stay in the intensive care unit, a longer hospital length of stay, and mortality. An oxygenator arterial outlet temperature greater than 37°C has been reported to be associated with AKI; however, the influence of other rewarming temperatures is unclear. Using multicenter registry data, this study aimed to evaluate the role of CPB rewarming temperatures on AKI...
May 2016: Annals of Thoracic Surgery
Aldjia Hocine, Pierre Defrance, Jacques Lalmand, Christian Delcour, Patrick Biston, Michaël Piagnerelli
BACKGROUND: To investigate the predictive value of decreased urine output based on the Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function and End-stage renal disease (RIFLE) classification on contrast- induced acute kidney injury (CA-AKI) in intensive care (ICU) patients. METHODS: All patients who received contrast media (CM) injection for CT scan or coronary angiography during a 3-year period in a 24 bed medico-surgical ICU were reviewed...
March 28, 2016: BMC Nephrology
Heng-Chih Pan, Yu-Shan Chien, Chang-Chyi Jenq, Ming-Hung Tsai, Pei-Chun Fan, Chih-Hsiang Chang, Ming-Yang Chang, Ya-Chung Tian, Ji-Tseng Fang, Chih-Wei Yang, Yung-Chang Chen
Critically ill cirrhotic patients have high mortality rates, particularly when they present with acute kidney injury (AKI) on admission. The Kidney Disease: Improving Global Outcomes (KDIGO) group aimed to standardize the definition of AKI and recently published a new AKI classification. However, the efficacy of the KDIGO classification for predicting outcomes of critically ill cirrhotic patients is unclear. We prospectively enrolled 242 cirrhotic patients from a 10-bed specialized hepatogastroenterology intensive care unit (ICU) in a 2000-bed tertiary-care referral hospital...
2016: Scientific Reports
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