An assessment of AKIN criteria for hospital-acquired acute kidney injury: a prospective observational cohort study.
OBJECTIVE
The Acute Kidney Injury Network (AKIN) criteria assert a new definition for acute kidney injury (AKI). We investigated the incidence of hospital-acquired AKI, along with the clinical characteristics and outcomes in hospitalized patients according to AKIN stage.


METHODS
We performed a prospective, observational, single-center study. We monitored serum creatinine everyday for all patients using a hospital data survey system during the study period from September 2007 to February 2008.


RESULTS
Hospital-acquired AKI occurred in 1.2% of all hospitalized patients during the study period. Among patients with AKI, 29.2% were in stage 1, 36.5% were in stage 2 and 34.4% were in stage 3. A significantly higher rate of renal recovery was observed in patients with lower-stage injuries (71.4, 60.0, and 21.2% for stages 1, 2, and 3, respectively). Mortality for patients with stage 3 AKI (51.5%) was significantly higher than that for patients with stages 1 or 2 (p < 0.013). Independent risk factors for mortality in patients with AKI included malignancy, stage 3 AKI, diuretic use, and intensive care unit admission prior to AKI.


CONCLUSIONS
Our findings support the utility of the AKIN criteria for hospital-acquired AKI, and demonstrate that stage 3 AKI poses a significant risk for poor patient and renal outcomes.
Kwon
Soon Hyo
SH
Hyonam Kidney Laboratory, Soon Chun Hyang University Hospital, Seoul, Korea.
Noh
Hyunjin
H
Jeon
Jin Seok
JS
Kim
Yongbae
Y
Han
Dong Cheol
DC
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D004231:Diuresis; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data; D007676:Kidney Failure, Chronic / Q000628:therapy; D007677:Kidney Function Tests; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D017582:Renal Replacement Therapy; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
D003404:Creatinine