Modified RIFLE criteria in critically ill children with acute kidney injury
Modified RIFLE criteria in critically ill children with acute kidney injury
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DOI：
10.1038/sj.ki.5002231
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发表时间：
2007-05-01
影响因子：
19.6
通讯作者：
Goldstein, S. L.
中科院分区：
文献类型：
--
作者：
Akcan-Arikan, A.;Zappitelli, M.;Goldstein, S. L.
提出了一个分类系统，以标准化成人急性肾损伤的定义。这些风险、损伤、衰竭、损失和终末期肾病的标准被赋予步枪的首字母缩写。我们基于150例危重儿科步枪（pRIFLE）患者修改了标准，以评估急性肾损伤发生率和病程沿着肾脏和/或非肾脏合并症。在这些儿童中，11人需要透析，24人死亡。在重症监护入院的第一周没有急性肾损伤的患者随后发生肾损伤或肾衰竭的可能性较小;然而，82%的急性肾损伤发生在最初的一周。在这组123名儿童中，60名达到风险的pRIFLEmax，32名达到损伤，31名达到失败。入院时急性肾损伤是重症监护的独立预测因素;住院时间和死亡风险增加独立于儿科死亡风险（PRISM II）评分（优势比3.0）。我们的研究结果表明，大多数重症儿童发生急性肾损伤的pRIFLE标准，并在重症监护过程中的早期。急性肾损伤与死亡率相关，并可能导致住院费用增加。我们认为pRIFLE标准可以用来描述危重患儿急性肾损伤的模式。
A classification system has been proposed to standardize the definition of acute kidney injury in adults. These criteria of risk, injury, failure, loss, and end-stage renal disease were given the acronym of RIFLE. We have modified the criteria based on 150 critically ill pediatric RIFLE (pRIFLE) patients to assess acute kidney injury incidence and course along with renal and/or non- renal comorbidities. Of these children, 11 required dialysis and 24 died. Patients without acute kidney injury in the first week of intensive care admission were less likely to subsequently develop renal Injury or Failure; however, 82% of acute kidney injury occurred in this initial week. Within this group of 123 children, 60 reached pRIFLEmax for Risk, 32 reached Injury, and 31 reached Failure. Acute kidney injury during admission was an independent predictor of intensive care; hospital length of stay and an increased risk of death independent of the Pediatric Risk of Mortality (PRISM II) score (odds ratio 3.0). Our results show that a majority of critically ill children develop acute kidney injury by pRIFLE criteria and do so early in the course of intensive care. Acute kidney injury is associated with mortality and may lead to increased hospital costs. We suggest that the pRIFLE criteria serves to characterize the pattern of acute kidney injury in critically ill children.