title: An assessment of the Acute Kidney Injury Network creatinine-based criteria in patients submitted to mechanical ventilation.
abstract: OBJECTIVE
  The aim of our study was to assess the new diagnostic criteria of acute kidney injury (AKI) proposed by the Acute Kidney Injury Network (AKIN) in a large cohort of mechanically ventilated patients.
  
  
  METHODS
  This is a prospective observational cohort study enrolling 2783 adult intensive care unit patients under mechanical ventilation (MV) with data on serum creatinine concentration (SCr) in the first 48 hours. The absolute and the relative AKIN diagnostic criteria (changes in SCr ≥ 0.3 mg/dl or ≥ 50% over the first 48 hours of MV, respectively) were analyzed separately. In addition, patients were classified into three groups according to their change in SCr (ΔSCr) over the first day on MV (ΔSCr): group 1, ΔSCr ≤ -0.3 mg/dl; group 2, ΔSCr between -0.3 and +0.29 mg/dl; and group 3, ΔSCr ≥ +0.3 mg/dl). The primary end point was in-hospital mortality, and secondary end points were intensive care unit and hospital length of stay, and duration of MV.
  
  
  RESULTS
  Of 2783 patients, 803 (28.8%) had AKI according to both criteria: 431 only absolute (AKI(A)), 362 both relative and absolute (AKI(R+A)), and 10 only relative. The relative criterion identified more patients when baseline SCr (SCr₀) was <0.9 mg/dl and the absolute when SCr₀ was >1.5 mg/dl. The diagnosis of AKI was associated with mortality.
  
  
  CONCLUSIONS
  Our study confirms the validity of the AKIN criteria in a population of mechanically patients and the criteria's relationship with the baseline SCr.
authors.affiliation: Instituto Médico de Previsión y Asistencia IMPASA, Montevideo, Uruguay.
authors.forename: Raúl
authors.initials: R
authors.lastname: Lombardi
authors.forename: Nicolás
authors.initials: N
authors.lastname: Nin
authors.forename: José A
authors.initials: JA
authors.lastname: Lorente
authors.forename: Fernando
authors.initials: F
authors.lastname: Frutos-Vivar
authors.forename: Niall D
authors.initials: ND
authors.lastname: Ferguson
authors.forename: Javier
authors.initials: J
authors.lastname: Hurtado
authors.forename: Carlos
authors.initials: C
authors.lastname: Apezteguia
authors.forename: Pablo
authors.initials: P
authors.lastname: Desmery
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Raymondos
authors.forename: Vinko
authors.initials: V
authors.lastname: Tomicic
authors.forename: Nahit
authors.initials: N
authors.lastname: Cakar
authors.forename: Marco
authors.initials: M
authors.lastname: González
authors.forename: José
authors.initials: J
authors.lastname: Elizalde
authors.forename: Peter
authors.initials: P
authors.lastname: Nightingale
authors.forename: Fekri
authors.initials: F
authors.lastname: Abroug
authors.forename: Manuel
authors.initials: M
authors.lastname: Jibaja
authors.forename: Yaseen
authors.initials: Y
authors.lastname: Arabi
authors.forename: Rui
authors.initials: R
authors.lastname: Moreno
authors.forename: Dimitros
authors.initials: D
authors.lastname: Matamis
authors.forename: Antonio
authors.initials: A
authors.lastname: Anzueto
authors.forename: Andrés
authors.initials: A
authors.lastname: Esteban
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002170:Canada; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood*; D005060:Europe; D005260:Female; D006305:Health Status Indicators; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012121:Respiration, Artificial; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia; D012720:Severity of Illness Index; D013020:South America; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D015415:Biomarkers; D003404:Creatinine