title: An evaluation of the RIFLE criteria for acute kidney injury after myeloablative allogeneic haematopoietic stem cell transplantation.
abstract: BACKGROUND
  Patients undergoing myeloablative allogeneic haematopoietic stem cell transplantation (HSCT) have a higher incidence of acute kidney injury (AKI). RIFLE is a newly developed classification for AKI that includes three grades of severity - AKI-R, AKI-I, AKI-F.
  
  
  OBJECTIVE
  The purpose of this study was to analyse retrospectively major risk factors for AKI at the time of myeloablative allo-HSCT and to use the RIFLE criteria to predict mortality in myeloablative allo-HSCT.
  
  
  METHODS
  Renal function was evaluated in 143 patients with allo-HSCT by RIFLE criteria in order to assess the incidence, risk factors and mortality rate of various degrees of AKI.
  
  
  RESULTS
  The results of this study showed that patients with hepatic veno-occlusive disease (HVOD) have a higher incidence of AKI-F than those without HVOD (P = 0.002). The incidence of AKI-I and AKI-F in patients with grade III-IV acute graft-versus-host disease (aGVHD) and increased total bilirubin was significantly higher than in those without (P = 0.001, P <0.001). HVOD was an independent risk factor of AKI-F (OR 5.058, 95% CI 1.317-19.424, P = 0.018), and increased total bilirubin was an independent risk factor for AKI-F (OR 5.126, 95% CI 1.403-18.998, P = 0.014). Worsening RIFLE category was associated with increased mortality of the patients in the 100 days post-transplant (P = 0.003). In addition, 180-day survival of patients in different AKI classes was significantly different (P = 0.0095).
  
  
  CONCLUSIONS
  AKI is common in patients with myeloablative allo-HSCT and is associated with increased risk of death. The RIFLE criteria appear to be an important tool for stratification of these patients on the basis of death risk.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Yu-Shi
authors.initials: YS
authors.lastname: Bao
authors.forename: Ru-Juan
authors.initials: RJ
authors.lastname: Xie
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.forename: Si-Zhou
authors.initials: SZ
authors.lastname: Feng
authors.forename: Ming-Zhe
authors.initials: MZ
authors.lastname: Han
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D001663:Bilirubin / Q000097:blood; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006504:Hepatic Veno-Occlusive Disease / Q000150:complications*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D019172:Transplantation Conditioning; D055815:Young Adult
chemical_list: D001663:Bilirubin