Advanced age affects the outcome-predictive power of RIFLE classification in geriatric patients with acute kidney injury

作者：Chao Chia Ter; Wu Vin Cent; Lai Chun Fu; Shiao Chih Chung; Huang Tao Min; Wu Pei Chen; Tsai I Jung; Hou Chun Cheng; Wang Wei Jie; Tsai Hung Bin; Lin Yu Feng; Chiang Wen Chih; Lin Shuei Liong; Tsai Pi Ru; Ko Wen Je; Wu Ming Shiou^*; Wu Kuan Dun

来源：Kidney International, 2012, 82(8): 920-927.

DOI：10.1038/ki.2012.237

• acute kidney injury
• geriatrics
• intensive care unit
• mortality

The RIFLE (risk, injury, failure, loss, and end-stage) classification is widely used to gauge the severity of acute kidney injury, but its efficacy has not been formally tested in geriatric patients. To correct this we conducted a prospective observational study in a multicenter cohort of 3931 elderly patients (65 years of age or older) who developed acute kidney injury in accordance with the RIFLE creatinine criteria after major surgery. We studied the predictive power of the RIFLE classification for in-hospital mortality and investigated the potential interaction between age and RIFLE classification. In general, the survivors were significantly younger than the nonsurvivors and more likely to have hypertension. In patients 76 years of age and younger, RIFLE-R, -I, or -F classifications were significantly associated with increased hospital mortality in a stepwise manner. There was no significant difference, however, in hospital mortality in those over 76 years of age between patients with RIFLE-R and RIFLE-I, although RIFLE-F patients had significantly higher mortality than both groups. Thus, the less severe categorizations of acute kidney injury per RIFLE classification may not truly reflect the adverse impact on elderly patients. Kidney International (2012) 82, 920-927; doi:10.1038/ki.2012.237; published online 4 July 2012

• 出版日期2012-10