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Impact of a new definition of acute kidney injury based on creatinine kinetics in cardiac surgery patients: A comparison with the RIFLE classification

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dc.contributor.author Garrido Jiménez, José Manuel
dc.contributor.author Candela-Toha, A. M.
dc.contributor.author Parise-Roux, D.
dc.contributor.author Tenorio, M.
dc.contributor.author Abraira, V.
dc.contributor.author Rey, J. M. del
dc.contributor.author Prada, B.
dc.contributor.author Ferreiro, Andrea
dc.contributor.author Liaño, F.
dc.date.accessioned 2015-05-05T10:27:44Z
dc.date.available 2015-05-05T10:27:44Z
dc.date.issued 2015
dc.identifier.citation Garrido, J. M., Candela-Toha, A. M., Parise-Roux, D., Tenorio, M., Abraira, V., del Rey, J. M., ... & Liaño, F. (2015). Impact of a new definition of acute kidney injury based on creatinine kinetics in cardiac surgery patients: A comparison with the RIFLE classification. Interactive Cardiovascular and Thoracic Surgery, 20(3), 338-44. spa
dc.identifier.issn 15699293 spa
dc.identifier.uri http://hdl.handle.net/11268/3940
dc.description.abstract OBJECTIVES: Acute kidney injury (AKI) after cardiac surgery is associated with adverse patient outcome. A new definition and staging system for AKI based on creatinine kinetics (CKs) has been proposed recently. Their proponents hypothesize that early absolute increases in serum creatinine (sCr) after kidney injury are superior to percentage increases, especially in patients with chronic kidney disease (CKD). The aims of our study were to measure agreement between CK definition and the current consensus definition [risk, injury, failure, loss and end-stage renal disease (RIFLE) system], and to compare time to diagnosis and prognostic value between both systems. METHODS: Retrospective cohort study. Agreement on AKI diagnosis by both classifications, time to diagnosis and prognostic value of both systems were compared in cardiac surgeries performed during a 6-year period (2002-2007) in a single centre. RESULTS: We found substantial agreement between both classifications (0.67). More patients were diagnosed with AKI by the CK definition than by RIFLE criteria both globally (28.2 vs 13.9%) and in every category (16.5 vs 8.4% for CK-1 vs RIFLE-R; 8.4 vs 3.6% for CK-2 vs RIFLE-I and 3.2 vs 2.0% for CK-3 vs RIFLE-F). Time to diagnosis was shorter for the CK definition (1.8 vs 2.5 days). Prognostic value in terms of information about in-hospital death and need for renal replacement was comparable between classifications. CONCLUSIONS: In cardiac surgery, the CK definition and classification system showed substantial agreement with the current standard, was more sensitive than RIFLE and detected AKI earlier without loss of prognostic information. spa
dc.language.iso eng spa
dc.title Impact of a new definition of acute kidney injury based on creatinine kinetics in cardiac surgery patients: A comparison with the RIFLE classification spa
dc.type article spa
dc.description.impact 1.329 JCR (2015) Q3, 91/124 Cardiac & cardiovascular systems spa
dc.identifier.doi 10.1093/icvts/ivu393
dc.rights.accessRights openAccess spa
dc.subject.uem Corazón - Cirugía spa
dc.subject.unesco Sistema cardiovascular spa
dc.subject.unesco Cirugía spa
dc.description.filiation UEM spa
dc.relation.publisherversion http://icvts.oxfordjournals.org/content/20/3/338.long spa
dc.peerreviewed Si spa


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