Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2013 Jul 23;8(7):e69998.
doi: 10.1371/journal.pone.0069998. Print 2013.

Incidence and mortality of acute kidney injury after myocardial infarction: a comparison between KDIGO and RIFLE criteria

Fernando B Rodrigues  1 , Rosana G Bruetto, Ulysses S Torres, Ana P Otaviano, Dirce M T Zanetta, Emmanuel A Burdmann
Affiliations
Comparative Study

Incidence and mortality of acute kidney injury after myocardial infarction: a comparison between KDIGO and RIFLE criteria

Fernando B Rodrigues et al. PLoS One. .

Abstract

Background: Acute kidney injury (AKI) increases the risk of death after acute myocardial infarction (AMI). Recently, a new AKI definition was proposed by the Kidney Disease Improving Global Outcomes (KDIGO) organization. The aim of the current study was to compare the incidence and the early and late mortality of AKI diagnosed by RIFLE and KDIGO criteria in the first 7 days of hospitalization due to an AMI.

Methods and results: In total, 1,050 AMI patients were prospectively studied. AKI defined by RIFLE and KDIGO occurred in 14.8% and 36.6% of patients, respectively. By applying multivariate Cox analysis, AKI was associated with an increased adjusted hazard ratio (AHR) for 30-day death of 3.51 (95% confidence interval [CI] 2.35-5.25, p<0.001) by RIFLE and 3.99 (CI 2.59-6.15, p<0.001) by KDIGO and with an AHR for 1-year mortality of 1.84 (CI 1.12-3.01, p=0.016) by RIFLE and 2.43 (CI 1.62-3.62, p<0.001) by KDIGO. The subgroup of patients diagnosed as non-AKI by RIFLE but as AKI by KDIGO criteria had also an increased AHR for death of 2.55 (1.52-4.28) at 30 days and 2.28 (CI 1.46-3.54) at 1 year (p<0.001).

Conclusions: KDIGO criteria detected substantially more AKI patients than RIFLE among AMI patients. Patients diagnosed as AKI by KDIGO but not RIFLE criteria had a significantly higher early and late mortality. In this study KDIGO criteria were more suitable for AKI diagnosis in AMI patients than RIFLE criteria.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: Co-author Emmanuel A. Burdmann is a PLOS ONE Editorial Board member. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and material.

Figures

Figure 1
Figure 1. Flow chart showing the total cohort, excluded patients and stratification by AKI severity grade according to the AKI criteria used (KDIGO or RIFLE).
AMI, acute myocardial infarction; SCr, serum creatinine; eGFR, estimated glomerular filtration rate; AKI, acute kidney injury; RIFLE, Risk, Injury, Failure, Loss, and End-stage kidney Disease; KDIGO, Kidney Disease: Improving Global Outcomes.
Figure 2
Figure 2. Hazard ratio (Cox multivariate analysis) for death at 30 days and at 30-day to 1-year follow-up according to the different AKI criteria.
AKI, acute kidney injury; RIFLE, Risk, Injury, Failure, Loss, and End-stage kidney Disease; KDIGO, Kidney Disease: Improving Global Outcomes.
Figure 3
Figure 3. Cox survival curve at 30 days according to the different AKI criteria.
A. RIFLE; B. KDIGO; C. KDIGO but not RIFLE. AKI, acute kidney injury; RIFLE, Risk, Injury, Failure, Loss, and End-stage kidney Disease; KDIGO, Kidney Disease: Improving Global Outcomes.
Figure 4
Figure 4. Cox survival curve at 30-days to 1-year according to the different AKI criteria.
A. RIFLE; B. KDIGO; C. KDIGO but not RIFLE. AKI, acute kidney injury; RIFLE, Risk, Injury, Failure, Loss, and End-stage kidney Disease; KDIGO, Kidney Disease: Improving Global Outcomes.
See this image and copyright information in PMC

References

    1. Bruetto RG, Rodrigues FB, Torres US, Otaviano AP, Zanetta DMT, et al. (2012) Renal function at hospital admission and mortality due to acute kidney injury after myocardial infarction. PLoS One 7: e35496. - PMC - PubMed
    1. Goldberg A, Hammerman H, Petcherski S, Zdorovyak A, Yalonetsky S, et al. (2005) Inhospital and 1-year mortality of patients who develop worsening renal function following acute ST-elevation myocardial infarction. Am Heart J 150: 330–337. - PubMed
    1. Newsome BB, Warnock DG, McClellan WM, Herzog CA, Kiefe CI, et al. (2008) Long-term risk of mortality and end-stage renal disease among the elderly after small increases in serum creatinine level during hospitalization for acute myocardial infarction. Arch Intern Med 168: 609–616. - PubMed
    1. Parikh CR, Coca SG, Wang Y, Masoudi FA, Krumholz HM (2008) Long-term prognosis of acute kidney injury after acute myocardial infarction. Arch Intern Med 168: 987–995. - PubMed
    1. Marenzi G, Assanelli E, Campodonico J, De Metrio M, Lauri G, et al. (2010) Acute kidney injury in ST-segment elevation acute myocardial infarction complicated by cardiogenic shock at admission. Crit Care Med 38: 438–444. - PubMed

Publication types