Comparative Study of Akin Staging and Pediatric - Risk, Injury, Failure, Loss, End-stage Kidney Classification in Identifying Acute Kidney Injury in Critically Ill Children
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 2
Abstract
Introduction: Acute kidney injury (AKI) is a common comorbidity in critically ill children, associated with an increased risk of morbidity and mortality. Modern definitions of AKI based on changes in serum creatinine (Cr) and urine output (UO) are the risk, injury, failure, loss, end-stage kidney (RIFLE) classification, and AKI network (AKIN) staging. Aims and Objectives: The aim of this study was to compare AKIN staging and pediatric RIFLE (p-RIFLE) classification of AKI in critically ill children admitted to Paediatric Intensive Care Unit (PICU) at Institute of Child Health and Research Centre (ICH and RC), Madurai. Materials and Methods: A prospective observational study done in children 1 month – 12 years of age, admitted to PICU at ICH and RC, Madurai, over a period of 1 year. Demographic information, comorbidities, and serial serum Cr values were collected. UO was measured 6th hourly. AKI was defined by AKIN staging and p-RIFLE classification. Results analyzed using SPSS version 19. Results: In our study, total of 342 children were enrolled. 106 children had AKI by AKIN staging and 103 had AKI by p-RIFLE criteria, incidence being 31% and 30.1%, respectively. According to AKIN staging, Stage 1 included 43 (40.6%), Stage 2 included 28 (26.4%), Stage 3 included 35 (33%) cases. According to p-RIFLE classification, risk category included 35 (34%), injury category included 31 (30.1%), and failure category included 37 (35.9%) cases. The mortality rate was 42.5% (AKIN staging) and 43.6% (p-RIFLE classification). Mortality among the stages was 34.9%, 39.3%, and 54.3% in AKIN Stage 1, 2, and 3, respectively, with odds ratio of 0.59, 0.84, and 2.06, respectively. According to p-RIFLE, mortality was 37.1%, 38.7%, 54% in risk, injury, and failure class, respectively. There was no difference between AKIN staging and p-RIFLE classification in identifying AKI cases and predicting mortality. Conclusion: Both criteria correlate highly with outcome and demonstrate excellent inter-stage discrimination. Both were good predictors of mortality.
Authors and Affiliations
V Jakanattane, M Kulandaivel
Keywords
Related Articles
- EP ID EP466520
- DOI -
- Views 122
- Downloads 0
A Retrospective Survey to Assess the Skin Lightening, Skin Moisturization and Sensorial Properties of a Broad Spectrum Sunscreen Formulation in Indian Patients
Introduction: Indian people primarily use sunscreens to prevent tanning and maintain a fair complexion rather than preventing sunburns and cancers which are the internationally recommended reasons for use of sunscreens....
A Cross Sectional Study of Knowledge, Attitude and Practices about Menstruation and Menstrual Hygiene among Medical Students in Ranchi, Jharkhand
Introduction: Menstruation and menstrual practices are associated with taboos and sociocultural restrictions. Misconception and unhygienic practices associated with menstruation may cause adverse health outcomes. Undergr...
Surgical Management of Galeazzi Fractures - A Clinical Study of 42 Patients
Introduction: Fracture of the lower end of radius and Galeazzi fractures are common in orthopedic practice all over the world. The distal radioulnar joint disruption usually is simple in nature, which gets reduced sponta...
A Clinical Study on Transvaginal Ultrasonography and its Histopathological Correlation in the Diagnosis of Adenomyosis
Objective: The aim of this study is to evaluate the accuracy of transvaginal ultrasound (U/S) criteria in the diagnosis of adenomyosis and to correlate the U/S feature with histopathological results. Materials and Method...
Presentation and Outcome of Thoracic Injuries at a Tertiary Care Service Hospital
Introduction: Thoracic injuries account for a substantial proportion of all injury-related admissions, morbidity, and mortality in all service hospitals. It directly accounts for almost one-fifth of deaths resulting from...