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Definition and Diagnostic Criteria of Acute Kidney Injury

급성 신손상의 정의와 진단 기준

  • 남궁미경 (연세대학교 원주의과대학 소아청소년과)
  • Received : 2011.09.09
  • Accepted : 2011.10.13
  • Published : 2011.10.31

Abstract

Acute renal failure means that the word does not contain a mild kidney injury. In addition, the criteria for acute renal failure per researcher are different, and it is difficult in interpreting the results of research on acute renal failure. Therefore, rather than acute renal failure, a new term "acute kidney injury" meaning to include all the levels of injury is introduced. In 2002, to diagnose by means of serum creatinine, glomerular filtration rate and urine output, a detailed classification of acute kidney injury, the RIFLE criteria has been proposed. In 2007, the RIFLE criteria by transforming, AKIN criteria has been proposed. The pediatric RIFLE criteria for children has also been proposed. The author reviews here these criteria by comparing them.

급성신부전은 그 단어 의미에 약한 신장 손상을 포함하지 못한다. 또한 급성신부전에 대한 기준이 연구자마다 달라서 연구결과 해석상에 어려움을 주었다. 따라서 급성신부전보다는, 급성신손상이란 용어가, 신손상의 모든 정도를 포함하는 의미로 사용될 수 있다. 2002년에, 급성신손상을 자세히 분류하고 진단하기위해, 혈청크레아티닌, 사구체 여과율과 요량을 기준으로 하여, RIFLE 기준이 제안되었다. 2007년에는, RIFLE 기준을 변형하여, AKIN 기준이 제안되었다. 소아를 위해 소아-RIFLE 기준도 제안되었다. 저자는 여기서 이들 기준과 각각에 대한 비교를 기술하였다.

Keywords

References

  1. Smith HW. The kidney. Structural and Function in Health and Disease, New York: Oxford University Press, 1951.
  2. Bellomo R, Ronco C, Kellum JA, Metha RL, Palevsky P, the ADQI workgroup. Acute renal failure-definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:204-12.
  3. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, et al. Acute Kidney Injury Network. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:31-9.
  4. Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 2007;71:1028-35. https://doi.org/10.1038/sj.ki.5002231
  5. Hoste EA, Clermont G, Kersten A, Venkataraman R, Angus DC, De Bacquer D, et al. RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 2006; 10:73-82.
  6. Jaffe M Uber den Niederschlag, welchen Pikrinsaure in normalen Harn erzeugt und uber eine neue Reaktion des Kreatinins. Z Physiol Chem 1886:10:391-400.
  7. Piccinni P, Dan M, Barbacini S, Carraro R, Lieta E, Marafon S, et al. Early isovolaemic haemofiltration in oliguric patients with septic shock. Intensive Care Med 2006;32: 80-6. https://doi.org/10.1007/s00134-005-2815-x
  8. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al. Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005; 294:813-18. https://doi.org/10.1001/jama.294.7.813
  9. Palevsky PM, Zhang JH, O'Connor TZ, Chertow GM, Crowley ST, Choudhury D, et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 2008;359:7-20. https://doi.org/10.1056/NEJMoa0802639
  10. Joannidis M, Metnitz B, Bauer P, Schusterschitz N, Moreno R, Druml W, et al. Acute kidney injury in critically ill patients classified by AKIN versus RIFLE using the SAPS 3 database. Intensive Care Med 2009;35: 1692-702. https://doi.org/10.1007/s00134-009-1530-4
  11. Bagshaw SM, George C, Bellomo R. A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients. Nephrol Dial Transplant 2008;23:1569-74. https://doi.org/10.1093/ndt/gfn009
  12. Chang CH, Lin CY, Tian YC, Jenq CC, Chang MY, Chen YC, et al. Acute Kidney Injury Classification: Comparison of AKIN and RIFLE Criteria. Shock 2010:3:247-52.
  13. Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 1987; 34:571-90.
  14. Akcan-Arikan A, Zappitelli M, Loftis LL, Washburn KK, Jefferson LS, Goldstein SL. Modified RIFLE criteria in critically ill children with acute kidney injury. Kidney Int 2007;71:1028-35. https://doi.org/10.1038/sj.ki.5002231
  15. Schneider J, Khemani R, Grushkin C, Bart R. Serum creatinine as stratified in the RIFLE score for acute kidney injury is associated with mortality and length of stay for children in the pediatric intensive care unit. Crit Care Med 2010;38:933-9. https://doi.org/10.1097/CCM.0b013e3181cd12e1
  16. Plotz FB, Bouma AB, van Wijk JA, Kneyber MC, Bokenkamp A. Pediatric acute kidney injury in the ICU: an independent evaluation of pRIFLE criteria. Intensive Care Med 2008; 34:1713-7. https://doi.org/10.1007/s00134-008-1176-7
  17. Go AS, Parikh CR, Ikizler TA, Coca S, Siew ED, Chinchilli VM, et al. The assessment, serial evaluation, and subsequent sequelae of acute kidney injury (ASSESS-AKI) study: design and methods. BMC Nephrol 2010;27;11-22.