Acute kidney injury in critically ill patients: a comparison between the RIFLE, AKIN, CK, and KDIGO classifications

• Rania AMMAR

  university of sfax faculty of medecine of sfax

• Dr.Emna Ennouri

  University of Sfax, faculty of medecine of sfax

• Dr. Mabrouk Bahloul

  University of Sfax, faculty of medecine of sfax

• Dr.Chokri Ben Hamida

  University of Sfax, faculty of medecine of sfax

Purpose: To compare the incidence of acute kidney injury (AKI) and the ability to predict in-hospital mortality by using RIFLE, AKIN, CK, and KDIGO classifications in critically ill patients.

Methods: A prospective, observational, single-center study was conducted over a period of 6 months in our ICU. We included patients with age ≥18 years and in-hospital stay ≥ 48 hours. Results: we included 171 patients. The incidence of AKI using the RIFLE, AKIN, CK, and KDIGO criteria was 32.16%, 46.8%, 45%, and 46.8%, respectively. AKIN and KDIGO have the same results, and they were more sensitive than RIFLE (46.8% vs. 32.16%, p<0.001) and CK (46.8% vs. 45%, p<0.001). In-hospital mortality was significantly higher for AKI patients than for non-AKI patients regardless of the definition used: RIFLE (17.54% vs. 12.86%, p<0.0001), CK (23.39% vs. 7.01%, p<0.0001), and both KDIGO and AKIN (24.56% vs. 5.84%, p<0.0001). The talit rate of patients identified as AKI by KDIGO and AKIN was higher than Rp=0.000) and CK (24.56% vs. 23.39%, CK (24.56% vs. 23.39%, vs. 1vs174% p=0.000 and CK (24.56% vs. p=0.000). Compared with RIFLE and CK criteria, both KDIGO and AKIN had greater predictive ability for in-hospital mortality. The area-under-ROC curves for in-hospital mortality for RIFLE, AKIN, CK, and KDIGO criteria were 0.694, 0.761, 0.75, and 0.761, respectively.

Conclusion: KDIGO and AKIN identified more AKI patients and were more predictive for in-hospital mortality than RIFLE and CK.

1. Dr.Emna Ennouri, University of Sfax, faculty of medecine of sfax

   Medical resuscitation department of CHU Habib Bourguiba Teaching Hospital, Sfax Tunisia, University of Sfax, Tunisia

2. Dr. Mabrouk Bahloul, University of Sfax, faculty of medecine of sfax

   Medical resuscitation department of CHU Habib Bourguiba Teaching Hospital, Sfax Tunisia, University of Sfax, Tunisia

    

3. Dr.Chokri Ben Hamida, University of Sfax, faculty of medecine of sfax

   Medical resuscitation department of CHU Habib Bourguiba Teaching Hospital, Sfax Tunisia, University of Sfax, Tunisia

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