A comparison of three methods to estimate baseline creatinine for RIFLE classification

Závada, Jakub; Hoste, Eric; Cartin‐Ceba, Rodrigo; Calzavacca, Paolo; Gajić, Ognjen; Clermont, Gilles; Bellomo, Rinaldo; Kellum, John A.

doi:10.1093/ndt/gfp766

Cited by 224 publications

(179 citation statements)

References 30 publications

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“…In this study, and in accordance with current guidelines, baseline creatinine was back calculated from the MDRD assuming a 75 ml/kg per 1.73 m 2 GFR (35,47). Although this imputation was validated in previous works (48), it may overestimate the incidence of AKI by nearly 10% and may misclassify severity of AKI in up to 30% (49). Finally, the observational study design only allows us to conclude that ARDS was independently associated with AKI.…”

Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

170

159

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Background and objectives Increasing experimental evidence suggests that acute respiratory distress syndrome (ARDS) may promote AKI. The primary objective of this study was to assess ARDS as a risk factor for AKI in critically ill patients.Design, setting, participants, & measurements This was an observational study on a prospective database fed by 18 intensive care units (ICUs). Patients with ICU stays .24 hours were enrolled over a 14-year period. ARDS was defined using the Berlin criteria and AKI was defined using the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria. Patients with AKI before ARDS onset were excluded.Results This study enrolled 8029 patients, including 1879 patients with ARDS. AKI occurred in 31.3% of patients and was more common in patients with ARDS (44.3% versus 27.4% in patients without ARDS; P,0.001). After adjustment for confounders, both mechanical ventilation without ARDS (odds ratio [OR], 4.34; 95% confidence interval [95% CI], 3.71 to 5.10) and ARDS (OR, 11.01; 95% CI, 6.83 to 17.73) were independently associated with AKI. Hospital mortality was 14.2% (n=1140) and was higher in patients with ARDS (27.9% versus 10.0% in patients without ARDS; P,0.001) and in patients with AKI (27.6% versus 8.1% in those without AKI; P,0.001). AKI was associated with higher mortality in patients with ARDS (42.3% versus 20.2%; P,0.001).Conclusions ARDS was independently associated with AKI. This study suggests that ARDS should be considered as a risk factor for AKI in critically ill patients.

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Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

170

159

View full text Add to dashboard Cite

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“…Knowing the strengths and limitations of each approach is key to interpreting future study findings. For example, the accuracy of estimating a creatinine value using back-calculation from an eGFR of 75 ml/min/1.73 m 2 has been previously studied 44 . This approach is likely the most sensitive for detecting AKI among patients with no premorbid serum creatinine value and is anticipated to work well in populations with largely preserved kidney function.…”

Section: Baseline Creatinine Assessmentmentioning

confidence: 99%

Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

et al. 2017

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“…Baseline, admission, and reference serum creatinine were determined as previously described (8,9). We defined baseline creatinine as the lowest value of (1) the most recent prehospital creatinine value up to 1 year before the index hospital admission and (2) creatinine recorded in the first 24 hours of hospital admission.…”

Section: Study Cohortsmentioning

confidence: 99%

AKI in Low-Risk versus High-Risk Patients in Intensive Care

Sileanu

Murugan

Lucko

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives AKI in critically ill patients is usually part of multiorgan failure. However, nonrenal organ failure may not always precede AKI and patients without evidence of these organ failures may not be at low risk for AKI. This study examined the risk and outcomes associated with AKI in critically ill patients with and without cardiovascular or respiratory organ failures at presentation to the intensive care unit (ICU).Design, setting, participants, & measurements A large, academic medical center database, with records from July 2000 through October 2008, was used and the authors identified a low-risk cohort as patients without cardiovascular and respiratory organ failures defined as not receiving vasopressor support or mechanical ventilation within the first 24 hours of ICU admission. AKI was defined using Kidney Disease Improving Global Outcomes criteria. The primary end points were moderate to severe AKI (stages 2-3) and risk-adjusted hospital mortality.Results Of 40,152 critically ill patients, 44.9% received neither vasopressors nor mechanical ventilation on ICU day 1. Stages 2-3 AKI occurred less frequently in the low-risk patients versus high-risk patients within 24 hours (14.3% versus 29.1%) and within 1 week (25.7% versus 51.7%) of ICU admission. Patients developing AKI in both risk groups had higher risk of death before hospital discharge. However, the adjusted odds of hospital mortality were greater (odds ratio, 2.99; 95% confidence interval, 2.62 to 3.41) when AKI occurred in low-risk patients compared with those with respiratory or cardiovascular failures (odds ratio, 1.19; 95% confidence interval, 1.09 to 1.3); interaction P,0.001.Conclusions Patients admitted to ICU without respiratory or cardiovascular failure have a substantial likelihood of developing AKI. Although survival for low-risk patients is better than for high-risk patients, the relative increase in mortality associated with AKI is actually greater for low-risk patients. Strategies aimed at preventing AKI should not exclude ICU patients without cardiovascular or respiratory organ failures.

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A comparison of three methods to estimate baseline creatinine for RIFLE classification

Cited by 224 publications

References 30 publications

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup

AKI in Low-Risk versus High-Risk Patients in Intensive Care

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