title: Comparison of RIFLE and AKIN criteria in the evaluation of the frequency of acute kidney injury in post-liver transplantation patients.
abstract: BACKGROUND
  Acute renal dysfunction is presented quite often after orthotopic liver transplantation (LT), with a reported incidence of 12-64%. The "RIFLE" criteria were introduced in 2004 for the definition of acute kidney injury (AKI) in critically ill patients, and a revised definition was proposed in 2007 by the Acute Kidney Injury Network (AKIN), introducing the AKIN criteria. The aim of this study was to record the incidence of AKI in patients after LT by both classifications and to evaluate their prognostic value on mortality.
  
  
  METHODS
  We retrospectively evaluated the records of patients with LT over 2 years (2011-2012) and recorded the incidence of AKI as defined by the RIFLE and AKIN criteria. Preoperative and admission severity of disease scores, duration of mechanical ventilation, intensive care unit length of stay, and 30- and 180-day survivals were also recorded.
  
  
  RESULTS
  Seventy-one patients were included, with an average age of 51.78 ± 10.3 years. The incidence of AKI according to the RIFLE criteria was 39.43% (Risk, 12.7%; Injury, 12.7%; Failure, 14.1%), whereas according to the AKIN criteria it was 52.1% (stage I, 22.5%; stage II, 7%; stage II 22.55%). AKI, regardless of the classification used, was related to the Model for End-Stage Liver Disease score, the volume of transfusions, the duration of mechanical ventilation, and survival. The presence of AKI was related to higher mortality, which rose proportionally with the severity of AKI as defined by the stages of either the RIFLE or the AKIN criteria.
  
  
  CONCLUSIONS
  AKI classifications according to the RIFLE and AKIN criteria are useful tools in the recognition and classification of the severity of renal dysfunction in patients after LT, because they are associated with higher mortality, which rises proportionally with the severity of renal disease.
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece. Electronic address: aretikarapan@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Karapanagiotou
authors.affiliation: Department of Nephrology, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Dimitriadis
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Papadopoulos
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Kydona
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Kefsenidis
authors.affiliation: Department of Surgery and Transplantation, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Papanikolaou
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Gritsi-Gerogianni
mesh_terms: D058186:Acute Kidney Injury / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D058625:End Stage Liver Disease / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index