title: Prediction of clinical outcomes after kidney transplantation from deceased donors with acute kidney injury: a comparison of the KDIGO and AKIN criteria.
abstract: Acute kidney injury (AKI) is frequently detected in deceased donors (DDs), and it could be associated with adverse clinical outcomes in corresponding kidney transplant recipients (KTRs). In this regard, we sought to identify which criteria is better between the KDIGO and AKIN criteria for the diagnosis of AKI in DDs in the prediction of clinical outcomes after kidney transplantation (KT).
  
  
  
  Two hundred eighty-five cases of deceased donor kidney transplantation (DDKT) were included. We divided them into three groups; the non-AKI by both KDIGO and AKIN criteria group (n = 120), the AKI by KDIGO only group (n = 61), and the AKI by both criteria group (n = 104) according to the diagnosis of AKI using the KDIGO and AKIN criteria in the corresponding 205 DDs. We compared the development of delayed graft function (DGF), the change in allograft function, the allograft survival among the three groups.
  
  
  
  The incidence of DGF was significantly higher in the AKI by KDIGO only and the AKI by both criteria groups than in the non-AKI by both criteria group (P < 0.05 each). But no difference was detected between the AKI by KDIGO only group and the AKI by both criteria group (P > 0.05). Therefore, the KDIGO criteria had a better predictive value for DGF occurrence than the AKIN criteria (Area under the curve = 0.72 versus 0.63, P < 0.05) in Receiver Operation Characteristic analysis. On comparison of allograft function, the AKI by KDIGO only and the AKI by both criteria groups showed a significantly deteriorating pattern by 6 months after KT in comparison with the non-AKI by both criteria group (P < 0.05). However, the differences disappeared at 1 year from KT and long-term allograft survival did not differ among the three groups. AKI stage either by KDIGO or AKIN in DDs did not affect long-term allograft survival in corresponding KTRs as well.
  
  
  
  The KDIGO criteria may be more useful for predicting DGF than the AKIN criteria. However, AKI or AKI stage by either criteria in DDs failed to affect long-term allograft outcomes in KTRs.
authors.affiliation: Transplant research center, Seoul, Korea.|Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-040, Seoul, Korea.
authors.forename: Jeong Ho
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Transplant research center, Seoul, Korea.|Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-040, Seoul, Korea.
authors.forename: Min Seok
authors.initials: MS
authors.lastname: Choi
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Ok
authors.initials: YO
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sun Ae
authors.initials: SA
authors.lastname: Yoon
authors.affiliation: Transplant research center, Seoul, Korea.|Department of Surgery, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: Ji-Il
authors.initials: JI
authors.lastname: Kim
authors.affiliation: Transplant research center, Seoul, Korea.|Department of Surgery, Seoul St. Mary's Hospital, Seoul, Korea.
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
authors.affiliation: Transplant research center, Seoul, Korea.|Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-040, Seoul, Korea.
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
authors.affiliation: Transplant research center, Seoul, Korea.|Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-040, Seoul, Korea.
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.affiliation: Transplant research center, Seoul, Korea.|Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-040, Seoul, Korea.
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
authors.affiliation: Transplant research center, Seoul, Korea.|Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-040, Seoul, Korea.
authors.forename: Yong-Soo
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Transplant research center, Seoul, Korea. chungbh@catholic.ac.kr.|Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, 505 Banpo-Dong, Seocho-Ku, 137-040, Seoul, Korea. chungbh@catholic.ac.kr.
authors.forename: Byung Ha
authors.identifier: 0000-0003-0048-5717
authors.initials: BH
authors.lastname: Chung
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D051799:Delayed Graft Function / Q000453:epidemiology*; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology*; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: AKIN; Acute kidney injury (AKI); Deceased donor (DD); KDIGO; Kidney transplantation (KT)