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. 2023;35(4):304-308.
doi: 10.5455/msm.2023.35.304-308.

Acute Kidney Injury Classifications in the Prediction of In-hospital Mortality and Renal Function Non-recovery

Aida Hamzic-Mehmedbasic  1 , Melina Mackic  1 , Damir Rebic  2 , Hajrudin Spahovic  3 , Ajla Arnautovic-Halimic  4 , Nadina Jakirlic  5
Affiliations

Acute Kidney Injury Classifications in the Prediction of In-hospital Mortality and Renal Function Non-recovery

Aida Hamzic-Mehmedbasic et al. Mater Sociomed. 2023.

Abstract

Background: In the last two decades diagnostic criteria for acute kidney injury (AKI) were developed: Risk, Injury, Failure, Loss of Kidney Function, End-Stage Kidney Disease (RIFLE), Acute Kidney Injury Network (AKIN), and Kidney Disease: Improving Global Outcomes (KDIGO) classifications.

Objective: The study aimed to determine the incidence of AKI based on the RIFLE, AKIN, and KDIGO criteria, as well as analyze their predictive value for mortality and renal function outcome.

Methods: This was a single-center prospective study of patients diagnosed with AKI. Acute kidney injury was defined and classified according to the RIFLE, AKIN, and KDIGO criteria. The outcomes were renal function outcome and in-hospital mortality.

Results: The incidence rates of AKI based on the RIFLE, AKIN, and KDIGO criteria were 13.4%, 14-36%, and 14.64%, respectively. Multiple regression analysis showed that higher stages of AKI according to the KDIGO criteria were independently associated with non-recovery of renal function (p=0.011). However, the predictive ability of RIFLE, AKIN and KDIGO classifications for renal function recovery was poor (Area Under the Receiver Operating Characteristics-AUROC=0.599, AUROC=0.637, AUROC=0.659, respectively). According to the RIFLE and AKIN criteria, in-hospital mortality was statistically significantly higher in stage Failure/3 (p=0.0403 and p=0.0329, respectively) compared to stages Risk/1 and Injury/2. Receiver Operating Characteristics (ROC) analysis showed that all three classifications had poor predictive ability for in-hospital mortality (AUROC=0.675, AUROC=0.66, AUROC=0.681).

Conclusions: KDIGO classification is an independent predictor of renal function non-recovery. However, by ROC analysis, all three classifications have poor predictive ability for renal function outcome and mortality.

Keywords: acute kidney injury; classifications; in-hospital mortality; renal function non-recovery.

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Conflict of interest statement

The authors do not have any conflicts of interest to disclose.

References

    1. Nateghi Haredasht F, Viaene L, Pottel H, De Corte W, Vens C. Predicting outcomes of acute kidney injury in critically ill patients using machine learning. Sci Rep. 2023;13(1):9864. - PMC - PubMed
    1. Pereira M, Rodrigues N, Godinho I, Gameiro J, Neves M, Gouveia J, et al. Acute kidney injury in patients with severe sepsis or septic shock: a comparison between the ‘Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease’ (RIFLE), Acute Kidney Injury Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO) classifications. Clin Kidney J. 2017;10(3):332–340. - PMC - PubMed
    1. Hoste EAJ, Kellum JA, Selby NM, Zarbock A, Palevsky PM, Bagshaw SM, et al. Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol. 2018;14(10):607–625. - PubMed
    1. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal failure–definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8(4):R204–12. - PMC - PubMed
    1. Acute Kidney Injury Network. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11(2):R31. - PMC - PubMed

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