title: Are we late for the diagnosis of acute kidney injury in the intensive care units in pediatric patients? A preliminary, retrospective observational study among 66 patients.
abstract: BACKGROUND
  The purposes of this study were to emphasize the importance of Risk, Injury, Failure, Loss, and End-Stage (RIFLE) classification in early diagnose and prognosis of acute kidney injury (AKI), and to evaluate the practicability of the RIFLE criteria in intensive care units.
  
  
  METHODS
  Sixty-six patients applied acute peritoneal dialysis were included into the study. Patients having acute peritoneal dialysis within the first 24 hours of intensive care unit admission were named group 1, between 24-48 hours group 2, and those who had acute peritoneal dialysis 48 hours or more after admission to the intensive care unit were named group 3. Retrospectively, we evaluated patients by RIFLE criteria at the consultation time, and patients who had been just in AKI were called late referral patients. The mean interval time between the onset of AKI and the consultation time was defined as delay time in late referral patients.
  
  
  RESULTS
  There were 20 patients in group 1, 15 were in group 2 and 31 in group 3. In total there were 18/66 patients in risk, 13/66 in injury while 35/66 in failure. There was statistically difference between delay times of in risk and failure class in group 3 (P<0.05). Also delayed patient numbers of both risk and failure class were found statistically highly significant (P<0.001).
  
  
  CONCLUSIONS
  Most of the patients were in failure class at the time of consultation. We guess that if they would have been diagnosed earlier, prognosis might have been better. Therefore early diagnosis of AKI with RIFLE criteria and early initiation of acute peritoneal dialysis would probably improve prognosis.
authors.affiliation: Department of Pediatric Nephrology, Ege University Faculty of Medicine Izmir, Izmir, Turkey - kcanturk1@hotmail.com.
authors.forename: Ipek
authors.initials: I
authors.lastname: Kaplan Bulut
authors.forename: Orhan D
authors.initials: OD
authors.lastname: Kara
authors.forename: Kadriye
authors.initials: K
authors.lastname: Ozdemir
authors.forename: Nida
authors.initials: N
authors.lastname: Dincel
authors.forename: Ebru
authors.initials: E
authors.lastname: Yilmaz
authors.forename: Mustafa O
authors.initials: MO
authors.lastname: Bulut
authors.forename: Betul
authors.initials: B
authors.lastname: Sozeri
authors.forename: Hasan
authors.initials: H
authors.lastname: Bicer
authors.forename: Sevgi
authors.initials: S
authors.lastname: Mir
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D008297:Male; D010530:Peritoneal Dialysis / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors