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Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality
Our study evaluated the differences between early and late hemodialysis (HD) initiation in the intensive care unit (ICU) according to the RIFLE (Risk, Injury, Failure, Loss, and End-stage renal failure) and AKIN (Acute Kidney Injury Network) classifications. On the assumption that early initiation o...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Iranian Journal of Medical Sciences
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523048/ https://www.ncbi.nlm.nih.gov/pubmed/28761207 |
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author | Kara, Iskender Yildirim, Fatma Kayacan, Esra Bilaloğlu, Burcu Turkoglu, Melda Aygencel, Gülbin |
author_facet | Kara, Iskender Yildirim, Fatma Kayacan, Esra Bilaloğlu, Burcu Turkoglu, Melda Aygencel, Gülbin |
author_sort | Kara, Iskender |
collection | PubMed |
description | Our study evaluated the differences between early and late hemodialysis (HD) initiation in the intensive care unit (ICU) according to the RIFLE (Risk, Injury, Failure, Loss, and End-stage renal failure) and AKIN (Acute Kidney Injury Network) classifications. On the assumption that early initiation of HD in critical patients according to the RIFLE and AKIN criteria decreases mortality, we retrospectively evaluated the medical records of 68 patients in our medical ICU and divided the patients into 2 groups: Those undergoing HD in no risk, risk, or injury stage according to RIFLE and in stage 0, I, or II according to AKIN were defined as early HD and those in failure stage according to RIFLE and in stage III according to AKIN were defined as late HD. The median age of the patients was 66.5 years, and 56.5% were male. HD was started in 25% and 39.7% of the patients in the early stage in the RIFLE and AKIN classification, respectively. According to RIFLE, HD was started in 61.5% of the surviving patients in the early stage; this rate was 16.4% in the deceased patients (P=0.001). HD was commenced in 69.2% of the surviving patients in AKIN stages 0, I, and II and in 32.7% of the deceased patients (P=0.026). Sepsis (61.5% vs. 94.5%; P=0.001) and mechanical ventilation (30.8% vs. 87.3%; P<0.001) during HD increased ICU mortality, whereas HD initiation in the early stages according to RIFLE decreased ICU mortality (61.5% vs. 16.4%; P=0.001). In conclusion, in critically ill patients, HD initiation in the early stages according to the RIFLE classification decreased our ICU mortality. |
format | Online Article Text |
id | pubmed-5523048 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Iranian Journal of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-55230482017-07-31 Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality Kara, Iskender Yildirim, Fatma Kayacan, Esra Bilaloğlu, Burcu Turkoglu, Melda Aygencel, Gülbin Iran J Med Sci Brief Report Our study evaluated the differences between early and late hemodialysis (HD) initiation in the intensive care unit (ICU) according to the RIFLE (Risk, Injury, Failure, Loss, and End-stage renal failure) and AKIN (Acute Kidney Injury Network) classifications. On the assumption that early initiation of HD in critical patients according to the RIFLE and AKIN criteria decreases mortality, we retrospectively evaluated the medical records of 68 patients in our medical ICU and divided the patients into 2 groups: Those undergoing HD in no risk, risk, or injury stage according to RIFLE and in stage 0, I, or II according to AKIN were defined as early HD and those in failure stage according to RIFLE and in stage III according to AKIN were defined as late HD. The median age of the patients was 66.5 years, and 56.5% were male. HD was started in 25% and 39.7% of the patients in the early stage in the RIFLE and AKIN classification, respectively. According to RIFLE, HD was started in 61.5% of the surviving patients in the early stage; this rate was 16.4% in the deceased patients (P=0.001). HD was commenced in 69.2% of the surviving patients in AKIN stages 0, I, and II and in 32.7% of the deceased patients (P=0.026). Sepsis (61.5% vs. 94.5%; P=0.001) and mechanical ventilation (30.8% vs. 87.3%; P<0.001) during HD increased ICU mortality, whereas HD initiation in the early stages according to RIFLE decreased ICU mortality (61.5% vs. 16.4%; P=0.001). In conclusion, in critically ill patients, HD initiation in the early stages according to the RIFLE classification decreased our ICU mortality. Iranian Journal of Medical Sciences 2017-07 /pmc/articles/PMC5523048/ /pubmed/28761207 Text en Copyright: © Iranian Journal of Medical Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Brief Report Kara, Iskender Yildirim, Fatma Kayacan, Esra Bilaloğlu, Burcu Turkoglu, Melda Aygencel, Gülbin Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality |
title | Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality |
title_full | Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality |
title_fullStr | Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality |
title_full_unstemmed | Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality |
title_short | Importance of RIFLE (Risk, Injury, Failure, Loss, and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality |
title_sort | importance of rifle (risk, injury, failure, loss, and end-stage renal failure) and akin (acute kidney injury network) in hemodialysis initiation and intensive care unit mortality |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523048/ https://www.ncbi.nlm.nih.gov/pubmed/28761207 |
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