An Assessment of the Acute Kidney Injury Network Creatinine-Based Criteria in Patients Submitted to Mechanical Ventilation

作者：Lombardi Raul; Nin Nicolas; Lorente Jose A; Frutos Vivar Fernando; Ferguson Niall D; Hurtado Javier; Apezteguia Carlos; Desmery Pablo; Raymondos Konstantinos; Tomicic Vinko; Cakar Nahit; Gonzalez Marco; Elizalde Jose; Nightingale Peter; Abroug Fekri; Jibaja Manuel; Arabi Yaseen; Moreno Rui; Matamis Dimitros; Anzueto Antonio; Esteban Andres^*

来源：Clinical Journal of the American Society of Nephrology, 2011, 6(7): 1547-1555.

DOI：10.2215/CJN.09531010

Background and objectives The aim of our study was to assess the new diagnostic criteria of acute kidney injury (AKI) proposed by the Acute Kidney Injury Network (AKIN) in a large cohort of mechanically ventilated patients.
Design, setting, participants, & measurements This is a prospective observational cohort study enrolling 2783 adult intensive care unit patients under mechanical ventilation (MV) with data on serum creatinine concentration (SCr) in the first 48 hours. The absolute and the relative AKIN diagnostic criteria (changes in SCr >= 0.3 mg/dl or >= 50% over the first 48 hours of MV, respectively) were analyzed separately. In addition, patients were classified into three groups according to their change in SCr (Delta SCr) over the first day on MV (Delta SCr): group 1, Delta SCr <= -0.3 mg/dl; group 2, Delta SCr between -0.3 and +0.29 mg/dl; and group 3, Delta SCr >= +0.3 mg/dl). The primary end point was in-hospital mortality, and secondary end points were intensive care unit and hospital length of stay, and duration of MV.
Results Of 2783 patients, 803 (28.8%) had AKI according to both criteria: 431 only absolute (AKI(A)), 362 both relative and absolute (AKI(R+A)), and 10 only relative. The relative criterion identified more patients when baseline SCr (SCr(0)) was <0.9 mg/dl and the absolute when SCr(0) was >1.5 mg/dl. The diagnosis of AKI was associated with mortality.
Conclusions Our study confirms the validity of the AKIN criteria in a population of mechanically patients and the criteria's relationship with the baseline SCr. Clin J Am Soc Nephrol 6: 1547-1555, 2011. doi: 10.2215/CJN.09531010

• 出版日期2011-7
• 单位河北医科大学