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Abstract

This study compared the RIFLE and AKIN criteria for diagnosing acute kidney injury (AKI) in 72 neurosurgery patients in the intensive care unit. The incidence of AKI was higher using the AKIN criteria (33.33%) compared to RIFLE (20.83%). Diabetes, low albumin, contrast use, blood loss during surgery, longer surgeries, low pre-op creatinine, more ventilator days, and higher APACHE II scores were associated with increased risk of developing AKI. The conclusion was that the incidence of AKI varies depending on the definition, and AKIN may better stage severity. Careful use of diuretics and fluids is important for accurate

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Vidit Joshi
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37 views

Abstract

This study compared the RIFLE and AKIN criteria for diagnosing acute kidney injury (AKI) in 72 neurosurgery patients in the intensive care unit. The incidence of AKI was higher using the AKIN criteria (33.33%) compared to RIFLE (20.83%). Diabetes, low albumin, contrast use, blood loss during surgery, longer surgeries, low pre-op creatinine, more ventilator days, and higher APACHE II scores were associated with increased risk of developing AKI. The conclusion was that the incidence of AKI varies depending on the definition, and AKIN may better stage severity. Careful use of diuretics and fluids is important for accurate

Uploaded by

Vidit Joshi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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ACUTE KIDNEY INJURY IN POST-OP NEUROSURGERY PATIENTS IN ICU:

A COMPARISON BETWEEN THE RIFLE AND THE AKIN CLASSIFICATIONS

BACKGROUND : Acute kidney injury (AKI) is a known complication after major surgery. Early
recognition of AKI can reduce morbidity and mortality. AKI have more than 30 published definitions
and therefore the wide variation in definitions has made it difficult for comparisons of and conclusions.
Recently four new definitions of Acute Kidney Injury have been proposed RIFLE, AKIN, KDIGO and
WRF of which later two mainly based ON AKIN criteria.
METHODOLOGY: To compare the RIFLE (Risk,Injury,Failure,Loss and End-stage Renal Failure)
and AKIN (Acute Kidney Injury Network) criteria for diagnosis of AKI after Neurosurgery in post
operative ICU patients and associated risk factors in the development of AKI. This is a Prospective
cohort study of 72 patients from December2012 to September2013 with post-op ICU stays >24 hours.
Other factors contributing to the onset of renal failure were analysed .statistical data was analysed using
SPSS 17.
RESULTS : The incidence of AKI using the AKIN and RIFLE criteria was 33.33% and 20.83%
(p<0.001) respectively, but individual patients were classified differently. Diabetes mellitus,
Hypoalbuminemia, contrast use, blood loss intra-op, duration of surgery, Low Pre-op creatinine,
Number of ventilatory days and APACHE II score were positively associated with AKI.
CONCLUSION : The incidence of AKI in critical patient varies depending on the definition used. The
stepwise incremental mortality risk by AKI severity stage is better in AKIN. Use of Diuretics and iv
fluids must be consider for accurate identification and staging of AKI. AKIN applied in patient
undergoing Neurosurgery without correction of Sr Creatinine for fluid balance may lead to
overdiagnose AKI.

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