title: The RIFLE versus AKIN classification for incidence and mortality of acute kidney injury in critical ill patients: A meta-analysis.
abstract: The sensitivity and accuracy of the Risk/Injury/Failure/Loss/End-stage (RIFLE) versus acute kidney injury Network (AKIN) criteria for acute kidney injury (AKI) in critically ill patients remains uncertain. Therefore, we performed a systematic review and meta-analysis to investigate the incidence and prognostic value of the RIFLE versus AKIN criteria for AKI in critically ill patients. Literatures were identified by searching Medline, Embase, PubMed, and China National Knowledge Infrastructure (CNKI) database. Nineteen studies with 171,889 participants were included. The pooled estimates of relative risk (RR) were analyzed. We found that the RIFLE and AKIN criteria is different for the incidence of AKI in intensive care unit (ICU) patients (P = 0.02, RR = 0.88), while not for cardiac surgery patients (P = 0.30, RR = 0.93). For AKI-related hospital mortality, the AKIN criteria did not show a better ability in predicting hospital mortality in either ICU (P = 0.19, RR = 1.01) or cardiac surgery patients (P = 0.61, RR = 0.98) compared to RIFLE criteria. Our findings supported that the AKIN criteria can identify more patients in classifying AKI compared to RIFLE criteria, but not showing a better ability in predicting hospital mortality. Moreover, both RIFLE and AKIN criteria for AKI in cardiac surgery patients had better predictive ability compared with the ICU patients.
authors.affiliation: Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Jiachuan
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Department of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Zhangxue
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Nie
authors.affiliation: Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Yiqin
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Nephrology, Institute of Nephrology of Chongqing and Kidney Center of PLA, Xinqiao Hospital, Third Military Medical University, Chongqing, 400037, China.
authors.forename: Jinghong
authors.initials: J
authors.lastname: Zhao
mesh_terms: D058186:Acute Kidney Injury / Q000145:classification* / Q000401:mortality*; D019540:Area Under Curve; D013504:Cardiovascular Surgical Procedures / Q000401:mortality; D016638:Critical Illness / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D017594:Publication Bias; D012372:ROC Curve