The Risk Factorsand Outcome Ofacute Kidney Injury In The Intensive Care Units

Objective: This study was performed to describe clinicalcharacteristics and outcomes of patients with Acute kidney injury (AKI) inintensive care unit (ICU) patients in southwest China and to investigate theeffectiveness of APACHE Ⅲscores and the RIFLE(Risk–Injury–Failure–Loss–ESRD) classification for predicting prognosisMethods: We performed a retrospective study of patients who fulfilledAKI criteria in ICU at The First Affiliated Hospital of Chongqing MedicalUniversity in the period of Jan.2009to Dec.2011AKI was evaluatedaccording to the RIFLE classification. The APACHE Ⅲscores wereevaluated upon ICU admission. Data were analyzed using multivariatelogistic regression and receiver operating characteristic curve (ROC)estimate.Results: AKI occurred in169of the1076patients (16.6%) who wereadmitted during the study period.1%were classified as risk (R),3.4%asinjury (I), and12.1%as failure (F). The most common causes of AKI weresepsis (22.5%), and AKI was oliguric in55.6%of cases. A more advancedRIFLE category was associated with greater severity of illness measured by APACHE III score （P=0.018), more oliguric patients and the more patientsneeded renal replacement therapy （P=0.000）. The overall mortality rateof ICU patients was65%, in class F,65.7%in I, and54.5%in R. Inmultivariate analysis, APACHE Ⅲ scores and the number of organdamagewere independent risk factors for hospital mortality.Conclusions: The RIFLE classification is a simple and useful clinicaltool to detect and stratify the severity of AKI, but it may has less predictivepower for evaluating the prognosis of AKI patient. Baseline severity ofillness and the number of organ damage were independent risk factors forhospital mortality.