An assessment of the acute kidney injury network creatinine-based criteria in patients submitted to mechanical ventilation

Raúl Lombardi, Nicolás Nin, José A. Lorente, Fernando Frutos-Vivar, Niall D. Ferguson, Javier Hurtado, Carlos Apezteguia, Pablo Desmery, Konstantinos Raymondos, Vinko Tomicic, Nahit Cakar, Marco González, José Elizalde, Peter Nightingale, Fekri Abroug, Manuel Jibaja, Yaseen Arabi, Rui Moreno, Dimitros Matamis, Antonio AnzuetoAndrés Esteban

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Abstract

Background and objectives The aim of our study was to assess the new diagnostic criteria of acute kidney injury (AKI) proposed by the Acute Kidney Injury Network (AKIN) in a large cohort of mechanically ventilated patients. Design, setting, participants, & measurements This is a prospective observational cohort study enrolling 2783 adult intensive care unit patients under mechanical ventilation (MV) with data on serum creatinine concentration (SCr) in the first 48 hours. The absolute and the relative AKIN diagnostic criteria (changes in SCr ≥0.3 mg/dl or ≥50% over the first 48 hours of MV, respectively) were analyzed separately. In addition, patients were classified into three groups according to their change in SCr (ΔSCr) over the first day on MV (ΔSCr): group 1, ΔSCr ≤ -0.3 mg/dl; group 2, ΔSCr between -0.3 and +0.29 mg/dl; and group 3, ΔSCr ≥ +0.3 mg/dl). The primary end point was in-hospital mortality, and secondary end points were intensive care unit and hospital length of stay, and duration of MV. Results Of 2783 patients, 803 (28.8%) had AKI according to both criteria: 431 only absolute (AKIA), 362 both relative and absolute (AKIR+A), and 10 only relative. The relative criterion identified more patients when baseline SCr (SCr0) was <0.9 mg/dl and the absolute when SCr0 was >1.5 mg/dl. The diagnosis of AKI was associated with mortality. Conclusions Our study confirms the validity of the AKIN criteria in a population of mechanically patients and the criteria's relationship with the baseline SCr.

Original languageEnglish (US)
Pages (from-to)1547-1555
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number7
DOIs
StatePublished - Jul 1 2011

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ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Lombardi, R., Nin, N., Lorente, J. A., Frutos-Vivar, F., Ferguson, N. D., Hurtado, J., Apezteguia, C., Desmery, P., Raymondos, K., Tomicic, V., Cakar, N., González, M., Elizalde, J., Nightingale, P., Abroug, F., Jibaja, M., Arabi, Y., Moreno, R., Matamis, D., ... Esteban, A. (2011). An assessment of the acute kidney injury network creatinine-based criteria in patients submitted to mechanical ventilation. Clinical Journal of the American Society of Nephrology, 6(7), 1547-1555. https://doi.org/10.2215/CJN.09531010