Open AccessCOMPARISON OF TWO DEFINITIONS (p-RIFLE AND KDIGO) FOR PREVALENCE OF ACUTE KIDNEY INJURY AND IN HOSPITAL MORTALITY IN A PAEDIATRIC INTENSIVE CARE UNIT OF PAKISTAN
Author(s) -
Parveen Usman,
Habib Qaisar,
Anwar Ul Haque,
Qalab Abbas
Publication year - 2022
Publication title -
jamc. journal of ayub medical college, abbotabad, pakistan/journal of ayub medical college
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.195
H-Index - 31
eISSN - 1819-2718
pISSN - 1025-9589
DOI - 10.55519/jamc-01-9147
Subject(s) - rifle , medicine , acute kidney injury , kidney disease , interquartile range , retrospective cohort study , intensive care unit , receiver operating characteristic , intensive care medicine , emergency medicine , archaeology , history
Background: To compare the Paediatric RIFLE (p-RIFLE) and Kidney Disease Improving Global Outcomes (KDIGO) definitions of acute kidney injury (AKI) for frequency of (AKI) and in-hospital mortality in critically ill children. Methods: Retrospective review of medical records of all patients (aged 1 month – 16 years) admitted in Paediatric Intensive Care Unit from January 2015–December 2016, with length of stay >48 hours, was done. Patients with chronic kidney disease were excluded. Receiver operating characteristic (ROC) curves were used to evaluate the performance of the p-RIFLE and KDIGO criteria to predict the AKI related mortality. Logistic regression analysis was done to determine the association of different variables with mortality in AKI patient based on p-RIFLE, KDIGO. A p-value of <0.05 was considered significant. Results: Out of total 823 patients admitted during the study period, 562 patients were included in the study. Median age was 2 years (Interquartile range 8 years). AKI frequency according to p-RIFLE and KDIGO were 391 (70%), and 372 (66%) respectively. Overall, 106/823 (12.8%) children died during study period, 78 (19.9%) in AKI by p-RIFLE and 76 (20.4%) in AKI by KDIGO died. The area-under- curve for in-hospital mortality for p-RIFLE and KDIGO criteria were 0.525 (p=0.427), and 0.534 (p=0.276), respectively. Conclusion: P-RIFLE is more sensitive compared to KDIGO in diagnosing AKI in critically ill children; identifying a greater number of moderate staged AKI cases. Greater AKI severity is associated with higher mortality in critically ill children.