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Erschienen in: Critical Care 6/2009

01.06.2009 | Letter

RIFLE is not RIFLE: on the comparability of results

verfasst von: Lars Englberger, Rakesh M Suri, Hartzell V Schaff

Erschienen in: Critical Care | Ausgabe 6/2009

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Excerpt

In the consensus RIFLE criteria [1] of acute kidney injury (AKI) the thresholds given for serum creatinine (sCr) increase and glomerular filtration rate (GFR) decrease (Table 1) do not correspond [2]. Direct measurement of GFR in clinical practice is difficult, and values are more often estimated (eGFR) by the Cockroft-Gault equation or the Modification of Diet in Renal Disease (MDRD) formula. In addition, there is controversy in the literature whether eGFR provides more clinical information regarding AKI than changes in sCr [3].
Table 1
RIFLE criteria for the definition of acute kidney injury (urinary output criteria not listed)
RIFLE class
RIFLE criteria
R (risk)
≥ 1.5-fold increase in serum creatinine, or >25% decrease in GFR
I (injury)
≥ 2-fold increase in serum creatinine, or >50% decrease in GFR
F (failure)
≥ 3-fold increase in serum creatinine, or >75% decrease in GFR
Literatur
1.
Zurück zum Zitat 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: R204-212. 10.1186/cc2872PubMedCentralCrossRefPubMed 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: R204-212. 10.1186/cc2872PubMedCentralCrossRefPubMed
2.
Zurück zum Zitat Pickering JW, Endre ZH: GFR shot by RIFLE: errors in staging acute kidney injury. Lancet 2009, 373: 1318-1319. 10.1016/S0140-6736(09)60751-0CrossRefPubMed Pickering JW, Endre ZH: GFR shot by RIFLE: errors in staging acute kidney injury. Lancet 2009, 373: 1318-1319. 10.1016/S0140-6736(09)60751-0CrossRefPubMed
3.
Zurück zum Zitat Lippi G, Guidi GC: Acute kidney injury: time to shift from creatinine to the estimated glomerular filtration rate? Crit Care 2008, 12: 423. author reply 423 10.1186/cc6936PubMedCentralCrossRefPubMed Lippi G, Guidi GC: Acute kidney injury: time to shift from creatinine to the estimated glomerular filtration rate? Crit Care 2008, 12: 423. author reply 423 10.1186/cc6936PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A, Acute Kidney Injury Network: Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007, 11: R31. 10.1186/cc5713PubMedCentralCrossRefPubMed Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A, Acute Kidney Injury Network: Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007, 11: R31. 10.1186/cc5713PubMedCentralCrossRefPubMed
Metadaten
Titel
RIFLE is not RIFLE: on the comparability of results
verfasst von
Lars Englberger
Rakesh M Suri
Hartzell V Schaff
Publikationsdatum
01.06.2009
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 6/2009
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc8175

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