Chávez PJP, Sánchez VLD

Language: Spanish
References: 24
Page: 18-24
PDF size: 81.40 Kb.

ABSTRACT

Introduction: Renal ischemia is the leading cause of acute renal failure, there are variable degrees of renal failure that has been described and stratified.
Objectives: Define the epidemiology of the three steps of acute renal failure according to RIFLE criteria in mexican intensive care units (ICU).
Design: Descriptive, comparative, longitudinal, prospective, multicentric, interinstitutional study in a cohort of six years.
Places: 12 ICU of different public and private hospitals in Mexico City.
Subjects: 4,888 patients were included that had the RIFLE criteria.
Methods: Demographic, clinical variables, scales of severity of disease (APACHE II, Brussels score), use of resources (NEMS), and mortality were collected. The population under study was divided into three groups according to RIFLE classification of renal dysfunction: Group A (Risk), Group B (Injury) and group C (Failure). The statistical analysis consisted: descriptive statistic (means, standard deviations, proportions and incidence).
Results: 4,888 patients had the RIFLE criteria. The incidence for renal risk, injury and failure were of 197, 138 and 115 events per 1,000 patients-days, respectively. Between the patients with acute renal illness 602 (12.3%) had risk, 768 (15.7%) had injury and 3,518 (72.0%) had failure. Main etiologies were multisystemic organ failure in 1,676 patients (34%), and ischemia in 1,496 (30.7%). Only 360 (7.4%) patient needed dialysis.
Conclusions: This is the first epidemiologic and prospective study of the acute renal failure and its steps of renal dysfunction according to RIFLE criteria in the Mexican population of which we have concern.

REFERENCES

1. Molitoris BA, Sandoval R, Sutton TA. Endotelial injury and dysfunction in ischemic acute renal failure. Crit Care Med 2002;30(Suppl):S235-S240.

2. Liano F, Pascual J. Outcomes in acute renal failure. Semin Nephrol 1998;18:541-50.

3. Chertow GM, Christiansen CL, Cleary PD, et al. Prognostic stratification in critically ill patients with acute renal failure requiring dialysis. Arch Intern Med 1995;155:1505-11.

4. Belomo R, Ronco C, Kellum JA, et al, and the ADQI workgroup. Acute renal failure-definition, outcomes 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:R204-R212.

5. Kellum JA, Metha RL, Angus DC, et al, for the ADQI workgroup. The first international consensus conference on continuous renal replacement therapy. Kidney International 2002;62:1855-63.

6. Metha RL, Chertow GM. Acute renal failure definitions and classifications: time for change? J Am Soc Nephrol 2003;14:2178-87.

7. Abosaif NY, Tolba YA, Heap M, et al. The outcome of acute renal failure en the intensive care unit according to RIFLE: model application, sensitivity and predictability. Am J Kidney Dis 2005;46:1038-48.

8. Bell M, Liljestam E, Granath F, et al. Optimal follow-up time after continuous renal replacement therapy in actual renal failure patients stratified with RIFLE criteria. Nephrol Dial Transplant 2005;20:354-60.

9. Lopes JA, Jorge S, Neves FC, et al. An assessment of the rifle criteria for acute renal failure in severely burned patients. Nephrol Dial Transplant 2007;22:285.

10. Guitard J, Cointault O, Kamar N, et al. Acute renal failure following liver transplantation with induction therapy. Clin Nephrol 2006;65:103-12.

11. Kuitunen A, Vento A, Suojaranta-Ylinen R, et al. Acute renal failure alter cardiac surgery: evaluation of the RIFLE classification. Ann Thorac Surg 2006;81:542-6.

12. Maccariello E, Soares M, Valente C, et al. RIFLE classification in patients with acute kidney injury in need of renal replacement therapy. Intensive Care Med 2007;33:597-605.

13. Ali T, Khan I, Simpson W, et al. Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol 2007;18:1292-8.

14. Osterman M, Chang RW. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med 2007;35:1837-43.

15. Uchino S, Bellomo R, Goldsmith D, et al. An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med 2006;34:1913-7.

16. Hoste EA, Clermont G, Kersten A, et al. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 2006;10:R73-R82.

17. Bagshaw SM, George C, Dinu I, Bellomo R. A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant 2008;23:1203-10.

18. Joannidis M, Metnitz PG. Epidemiology and Natural History of Acute Renal Failure in the ICU. Crit Care Clin 2005;21:239-49.

19. Donnahoo K, Shames B, Harken D, Meldrum D. Review article: the role of tumor necrosis factor in renal ischemia-reperfusion injury. J Urol 1999;162:196-203.

20. Herget-Roshenthal S, Marggraf G, Husing J, et al Early detection of acute renal failure by serum cystatin C. Kidney Int 2004;66:1115-22.

21. Herget-Roshenthal S, Pietruck F, Volbracht L, et al. Serum cystatin C- a superior marker of rapidly reduced glomerular filtration after uninephrectomy in kidney donors compared to creatinine. Clin Nephrol 2005;64:41-6.

22. Han WK, Bailly V, Abichandani R, et al. Kidney Injury Molecule-1 (KIM-1): a novel biomarker for human renal proximal tubule injury. Kidney Int 2002;62:237-44.

23. Mishra J, Ma Q, Prada A, et al. Identification of neutrophil gelatinase-associated lipocalin as a novel early urinary biomarker for ischemic renal injury. J Am Soc Nephrol 2003;14:2534-43.

24. Parikh C, Abraham E, Ancukiewicz M, et al. Urine IL-18 is an early diagnostic marker for acute kidney injury and predicts mortality in the intensive care unit. J Am Soc Nephrol 2005;16:3046-52.