title: [The sensitivity and accuracy of RIFLE and AKIN criteria for acute kidney injury diagnosis in intensive care unit patients].
abstract: OBJECTIVE
  To evaluate the sensitivity/accuracy of 2 different acute kidney injury (AKI) diagnosis/classification criteria, the RIFLE (risk, injury, failure, loss of kidney function, end-stage kidney disease) and the acute kidney injury network (AKIN), for patients in intensive care unit (ICU).
  
  
  METHODS
  Clinical data were collected from all adult patients admitted to the Department of Intensive Medicine in Guangdong General Hospital between October 2009 and July 2010, and AKI cases were identified/classified using RIFLE and AKIN criteria separately, for statistical evaluation of their diagnostic sensitivity, and accuracy in hospital mortality prediction.
  
  
  RESULTS
  In all 524 patients evaluated, AKI were identified by RIFLE criteria in 95 of them, while by AKIN, 135. The AKI incidence by RIFLE (18.1%), and AKIN (25.8%) were significantly different (P < 0.05). Meanwhile, AKI incidence was found independent from the mortality, either by RIFLE or AKIN (both P < 0.001). In all patients, the area under the receiver operator characteristic curve (ROC curve), the index for hospital mortality prediction, was 0.7293 for RIFLE [with 95% confidence interval (95%CI) ranging from 0.6005 to 0.8581, P < 0.001], and for AKIN, 0.7777 (95%CI: 0.6664 - 0.8890, P < 0.001). No significant difference was found between the total hospital mortality by the two criteria (37.9% vs. 34.1%, P > 0.05).
  
  
  CONCLUSIONS
  Although AKIN criteria has higher sensitivity in AKI diagnosis, it is not different from the RIFLE criteria in predicting hospital mortality in critically ill patients.
authors.affiliation: Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong, China.
authors.forename: Fen
authors.initials: F
authors.lastname: Jiang
authors.forename: Yuan-han
authors.initials: YH
authors.lastname: Chen
authors.forename: Xin-ling
authors.initials: XL
authors.lastname: Liang
authors.forename: Li-xia
authors.initials: LX
authors.lastname: Xu
authors.forename: Guan-pei
authors.initials: GP
authors.lastname: Ma
authors.forename: Peng-hua
authors.initials: PH
authors.lastname: Hu
authors.forename: Shuang-xin
authors.initials: SX
authors.lastname: Liu
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000401:mortality*; D000328:Adult; D000368:Aged; D003422:Critical Care; D016638:Critical Illness / Q000145:classification / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D012015:Reference Standards; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index