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Dr. Vidit
Col(Dr) R
2
Ramprasad ,
Brig (Dr)G S
3
Ramesh
Pune.
2Associate Professor, Department of Anaesthesiology AFMC Pune
3Professor & HOD, Department of Anaesthesiology AFMC Pune
Introduction
Observation
Results
11
11
31-45 yrs
46-60 yrs
15
FEMALE
29 (40%)
10
5
0
< 30 yrs
No AKI
Failure
2 (3%)
Stage 2
1 (1%)
RISK
10 (14%)
> 60 yrs
AKI
Figure-5: Comparison of
AKIN & RIFLE
RIFLE
only
3 (4%)
Stage 3
4 (6%)
AKIN +
RIFLE
12 (17%)
Stage 1
19 (26%)
Objectives
AKIN
only
12 (17%)
No AKI
57 (79%)
No AKI
45 (62%)
15
5
IM
DAY 1
0
DAY3
DAY4
RIFLE
AKIN
DAY2
1
DAY5
AKI
Non AKI pMean(sd) Mean(sd) Value
Pre-op Cr (mg/dl)
0.83
(0.24)
Pre- Op Urea
29.11
(mg/dl)
(10.25)
Pre- Op K+ (mmol) 4.267
( 0.38)
Intra-Op Urine
1082.59
output (ml)
(963)
Intra-Op Blood loss 653.33
(ml)
(256)
Duration of Surgery 5.74
(hr)
(1.14)
APACHE score
8.33
(3.96)
0.96
(0.20)
22.68
(8.08)
4.193
(0.43)
956.89
(418)
529.33
(190)
4.84
(1.84)
6.04
(4.95)
0.018
0.795
0.470
0.446
0.022
0.013
0.045
Criteria
AKIN
RIFLE
Sr Creatinine
changes
Change
Within a 48hour
Over a one-week
period from
Baseline
Absolute S.Cr
increment in Stage 1
Rise of 0.3
mg/dL in 48
hrs
Renal replacement
therapy
Stage 3
No severity class
assigned
0
RIFLE
AKIN
RECOVERY
Criteria
Non
AKI(45)
AKI(27)
p-Value
Hypertension
16(22.2%)
8(29.6%)
8(17.8%)
0.258
Diabetes
15(20.8%)
10(37.0%)
5(11.1%)
0.015
Liver diseases
2(2.8%)
2(7.4%)
0(0%)
0.047
LVH/ CAD
3(4.2%)
3(11.1%)
0(0%)
0.049
Malignancy
12(16.7%)
4(14.8%)
8(17.8%)
1.000
Seizures
20(27.8%)
8(29.6%)
12(26.7%)
0.792
Immobilization
7(9.7%)
4(14.8%)
3(6.7%)
0.413
Chemotherapy
1(1.4%)
0(0%)
1(2.2%)
1.000
Contrast study
20(27.8%)
13(48.1%)
7(15.6%)
0.006
Transfusion
Reaction
Hypo
albuminemia
2(2.8%)
1(3.7%)
1(2.2%)
1.000
22(30.6%)
12(44.4%)
10(22.2%)
0.045
UO Criteria
AKIN GFR
CRITERIA
AKIN
CLASS
RISK
Increase Cr 1.5 Or
GFR decreases
>25%
UO < 0.5
ml/kg/hr
6 hr
Increase Cr
1.5 Or
0.3 mg/dl
STAGE 1
Increase Cr 2 Or
GFR decreases
> 50%
UO < 0.5
ml/kg/hr
12 hr
Increase Cr
2
STAGE 2
Increase Cr 3 Or
GFR decreases
> 75% Or
Cr 4mg/dl ( with
acute rise of
0.5 mg/dl)
UO < 0.3
ml/kg/hr
24 hr Or
Anuria 12
hr
Increase Cr
3 Or
Cr 4mg/dl (
with acute rise
of 0.5 mg/dl)
STAGE 3
INJURY
FAILURE
LOSS
ESRD
HIGHER GRADING
RIFLE
CLASS
DAY6
Discussion
10
5
1
0
DAY7
15
STAGE 1
19
10
23
20
Materials &
Methods
25
8
6
16
MALE
43 (60%)
Non AKI
48 (67%)
Conclusion
Diagnosis of early AKI was found to be
higher using the AKIN than RIFLE criteria
Whether there is over-diagnosis by AKIN
than RIFLE criteria cannot be interpreted in
this study.
References
1.
2.
3.
Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG,
et al. Acute Kidney Injury Network: report of an initiative to improve
outcomes in acute kidney injury.Crit Care. 2007;11:R31
Acknowledgement
We are grateful to the Col (Dr) S Singh, Gp Capt.(Dr) R M Sharma,
Lt Col. (Dr) R Goyal and Department of Anaesthesiology and
critical care, AFMC Pune for their kind guidence and support.