title: Pediatric acute kidney injury assessed by pRIFLE as a prognostic factor in the intensive care unit.
abstract: BACKGROUND
  In this study we applied the pediatric version of the RIFLE criteria (pRIFLE) to an at-risk hospital population, analyzed the incidence and association of acute kidney injury (AKI) with mortality and length of stay in both the intensive care unit (ICU) and the hospital, and evaluated the applicability of pRIFLE as a prognostic tool in the ICU.
  
  
  METHODS
  This study was a prospective single-center cohort study in which 126 patients were enrolled. The affected group included patients who were diagnosed with AKI. Subgroups of the diagnosed patients were established according to their maximum pRIFLE strata, which were defined as the worst pRIFLE score attained during the study period.
  
  
  RESULTS
  Fifty-eight (46 %) of our patients developed AKI. The lengths of stay in the ICU and in the hospital were longer in the affected group than in the unaffected group. The advanced strata of pRIFLEmax were associated with longer stays in the ICU and hospital and higher median Pediatric Index of Mortality II scores. The hospital mortality rate of AKI patients was 12-fold higher than that of the patients without AKI (36 vs. 3 %).
  
  
  CONCLUSIONS
  The incidence of AKI in this population was both significant and directly associated with hospital mortality and the length of stay in the ICU and hospital. The pRIFLE classification facilitated the definition of AKI, indicating that it a significant prognostic predictor.
authors.affiliation: Pediatric Intensive Care Unit, Hospital Infantil Joana de Gusmão, Florianópolis, Brazil. nilzete.bresolin@hotmail.com
authors.forename: Nilzete
authors.initials: N
authors.lastname: Bresolin
authors.forename: Aline Patrícia
authors.initials: AP
authors.lastname: Bianchini
authors.forename: Clarissa Alberton
authors.initials: CA
authors.lastname: Haas
mesh_terms: D058186:Acute Kidney Injury / Q000145:classification / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000652:urine; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine