Prevalence and Outcome of Acute Kidney Injury in the intensive care unit according to RIFLE criteria: A single-center study

Acute kidney injury (AKI) is common in the intensive care unit (ICU) and is associated with significant morbidity and mortality. This requires clinicians to be familiar with recent advances in definitions, diagnosis, prevention, and management of AKI in the ICU. The Acute Dialysis Quality Initiative (ADQI) represents the efforts of a workgroup seeking to develop consensus and evidence-based statements in the field of AKI. The ADQI group proposed a consensus graded definition, called the RIFLE criteria (Risk, Injury, Failure, Loss, and End stage). Objective: To estimate the prevalence of AKI in ICU and assess the ability of the RIFLE criteria to predict the outcome of AKI in ICU. Methods: We performed a retrospective cohort study in the internal medicine ICU, Zagazig University Hospital, in the period from January 2010 to December 2010. We excluded patients younger than 15 years, patients receiving chronic hemodialysis admitted to ICU, kidney transplant patients, length of hospital stays were <24 hours, or readmitted to the ICU during the study period. RIFLE criteria classified AKI patients into three stages of increasing severity Risk(R), Injury (I), and Failure (F). The outcomes of AKI patients in ICU were recovery, kidney loss, end stage renal disease (ESRD) or death. Results: The total number of ICU admissions during the study period was 8304 patients. After application of exclusion criteria, the number of the study became 5440 patients. According to RIFLE criteria 1885 (34.65%) had AKI. RIFLE criteria classified them into Risk 13.32%, Injury 11.91% and Failure 9.41%. The crude outcome of AKI patients as follow 77.24% recovered, 9% lost kidney functions and required renal replacement therapy (RRT), and 2.28% reached ESRD. The crude mortality of AKI patients was 20.47% versus 7.76% mortality in patients without AKI. The hospital recovery stratified by RIFLE criteria decreased with worsening RIFLE classes (R, I, F) 84.27%, 79.62% and 64.25% respectively. Patients' lost kidney functions and required RRT stratified by RIFLE criteria increased with worsening RIFLE classes 5.79%, 7.4% and15.62% respectively. Patients reached ESRD stratified by RIFLE criteria increased with worsening RIFLE classes 1.2%, 2% and 4.1% respectively. The hospital mortality AKI patients stratified by RIFLE criteria increased with worsening RIFLE classes 14.48%, 18.36% and 31.64% respectively. The urinary output (UOP) criteria associated with lower mortality and higher recovery rate than creatinine criteria. Conclusion: The prevalence of AKI in the internal medicine ICU, Zagazig University Hospital according to RIFLE criteria is 34.65%. RIFLE criteria are useful in predicting the outcome of AKI patients. [Mohamed Fouad and Mabrouk I. Ismail.Prevalence and Outcome of Acute Kidney Injury in the intensive care unit according to RIFLE criteria: A single-center study. Journal of American Science 2011; 7(6):1005-1012].(ISSN: 1545-1003). http://www.americanscience.org.