Comparison of Kidney Disease: Improving Global Outcomes and Acute Kidney Injury Network criteria for assessing patients in intensive care units

Hibiki Shinjo, Waichi Sato, Enyu Imai, Tomoki Kosugi, Hiroki Hayashi, Kunihiro Nishimura, Kimitoshi Nishiwaki, Yukio Yuzawa, Seiichi Matsuo, Shoichi Maruyama

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: The Kidney Disease: Improving Global Outcomes (KDIGO) group proposed to adopt the 48-h time window for the 0.3  mg/dL rise in serum creatinine (sCr) proposed by the Acute Kidney Injury Network (AKIN) group as a modification to the original risk, injury, failure, loss, and end-stage renal disease criteria, keeping the 7-day window for the 50 % increase in sCr from baseline. The present study evaluates the prevalence of acute kidney injury (AKI) and the accuracy of predicting mortality based on the KDIGO and AKIN criteria.

Patients and methods: We retrospectively studied a cohort of 2579 patients admitted to the intensive care unit of Nagoya University Hospital between 2005 and 2009.

Results: The total AKI prevalence was higher according to the KDIGO than to the AKIN criteria (38.4 versus 29.5 %). In-hospital mortality rates were higher among 238 patients classified as non-AKI by the AKIN but AKI by the KDIGO criteria than among those classified as non-AKI by both criteria (7.1 versus 2.7 %). Survival curves generated using KDIGO significantly differed among all stages, but not between AKIN stages I and II. Multivariate analysis showed that KDIGO criteria were better in a statistical model than the AKIN criteria according to the Akaike information criterion. Harrell’s C statistic was greater for the KDIGO than for the AKIN criteria.

Conclusions: The KDIGO criteria have improved sensitivity without compromising specificity for AKI and might predict mortality at least as well as the AKIN criteria.

Original languageEnglish
Pages (from-to)737-745
Number of pages9
JournalClinical and Experimental Nephrology
Volume18
Issue number5
DOIs
Publication statusPublished - 11-10-2014

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Kidney Diseases
Acute Kidney Injury
Intensive Care Units
Mortality
Creatinine
Kidney
Wounds and Injuries
Statistical Models
Hospital Mortality
Serum
Chronic Kidney Failure
Multivariate Analysis
Cross-Sectional Studies

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

Cite this

Shinjo, Hibiki ; Sato, Waichi ; Imai, Enyu ; Kosugi, Tomoki ; Hayashi, Hiroki ; Nishimura, Kunihiro ; Nishiwaki, Kimitoshi ; Yuzawa, Yukio ; Matsuo, Seiichi ; Maruyama, Shoichi. / Comparison of Kidney Disease : Improving Global Outcomes and Acute Kidney Injury Network criteria for assessing patients in intensive care units. In: Clinical and Experimental Nephrology. 2014 ; Vol. 18, No. 5. pp. 737-745.
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Comparison of Kidney Disease : Improving Global Outcomes and Acute Kidney Injury Network criteria for assessing patients in intensive care units. / Shinjo, Hibiki; Sato, Waichi; Imai, Enyu; Kosugi, Tomoki; Hayashi, Hiroki; Nishimura, Kunihiro; Nishiwaki, Kimitoshi; Yuzawa, Yukio; Matsuo, Seiichi; Maruyama, Shoichi.

In: Clinical and Experimental Nephrology, Vol. 18, No. 5, 11.10.2014, p. 737-745.

Research output: Contribution to journalArticle

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T2 - Improving Global Outcomes and Acute Kidney Injury Network criteria for assessing patients in intensive care units

AU - Shinjo, Hibiki

AU - Sato, Waichi

AU - Imai, Enyu

AU - Kosugi, Tomoki

AU - Hayashi, Hiroki

AU - Nishimura, Kunihiro

AU - Nishiwaki, Kimitoshi

AU - Yuzawa, Yukio

AU - Matsuo, Seiichi

AU - Maruyama, Shoichi

PY - 2014/10/11

Y1 - 2014/10/11

N2 - Background: The Kidney Disease: Improving Global Outcomes (KDIGO) group proposed to adopt the 48-h time window for the 0.3  mg/dL rise in serum creatinine (sCr) proposed by the Acute Kidney Injury Network (AKIN) group as a modification to the original risk, injury, failure, loss, and end-stage renal disease criteria, keeping the 7-day window for the 50 % increase in sCr from baseline. The present study evaluates the prevalence of acute kidney injury (AKI) and the accuracy of predicting mortality based on the KDIGO and AKIN criteria.Patients and methods: We retrospectively studied a cohort of 2579 patients admitted to the intensive care unit of Nagoya University Hospital between 2005 and 2009.Results: The total AKI prevalence was higher according to the KDIGO than to the AKIN criteria (38.4 versus 29.5 %). In-hospital mortality rates were higher among 238 patients classified as non-AKI by the AKIN but AKI by the KDIGO criteria than among those classified as non-AKI by both criteria (7.1 versus 2.7 %). Survival curves generated using KDIGO significantly differed among all stages, but not between AKIN stages I and II. Multivariate analysis showed that KDIGO criteria were better in a statistical model than the AKIN criteria according to the Akaike information criterion. Harrell’s C statistic was greater for the KDIGO than for the AKIN criteria.Conclusions: The KDIGO criteria have improved sensitivity without compromising specificity for AKI and might predict mortality at least as well as the AKIN criteria.

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