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首页> 美国卫生研究院文献>Iranian Journal of Medical Sciences >Importance of RIFLE (Risk Injury Failure Loss and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality
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Importance of RIFLE (Risk Injury Failure Loss and End-Stage Renal Failure) and AKIN (Acute Kidney Injury Network) in Hemodialysis Initiation and Intensive Care Unit Mortality

机译：RIFLE（风险损伤失败丧失和终末期肾衰竭）和AKIN（急性肾脏损伤网络）在血液透析开始和重症监护病房死亡率中的重要性

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摘要

Our study evaluated the differences between early and late hemodialysis (HD) initiation in the intensive care unit (ICU) according to the RIFLE (Risk, Injury, Failure, Loss, and End-stage renal failure) and AKIN (Acute Kidney Injury Network) classifications. On the assumption that early initiation of HD in critical patients according to the RIFLE and AKIN criteria decreases mortality, we retrospectively evaluated the medical records of 68 patients in our medical ICU and divided the patients into 2 groups: Those undergoing HD in no risk, risk, or injury stage according to RIFLE and in stage 0, I, or II according to AKIN were defined as early HD and those in failure stage according to RIFLE and in stage III according to AKIN were defined as late HD. The median age of the patients was 66.5 years, and 56.5% were male. HD was started in 25% and 39.7% of the patients in the early stage in the RIFLE and AKIN classification, respectively. According to RIFLE, HD was started in 61.5% of the surviving patients in the early stage; this rate was 16.4% in the deceased patients (P=0.001). HD was commenced in 69.2% of the surviving patients in AKIN stages 0, I, and II and in 32.7% of the deceased patients (P=0.026). Sepsis (61.5% vs. 94.5%; P=0.001) and mechanical ventilation (30.8% vs. 87.3%; P<0.001) during HD increased ICU mortality, whereas HD initiation in the early stages according to RIFLE decreased ICU mortality (61.5% vs. 16.4%; P=0.001). In conclusion, in critically ill patients, HD initiation in the early stages according to the RIFLE classification decreased our ICU mortality.
机译：我们的研究根据RIFLE（风险，伤害，衰竭，丢失和终末期肾衰竭）和AKIN（急性肾脏损伤网络）评估了重症监护病房（ICU）早期和晚期血液透析（HD）启动之间的差异。分类。假设根据RIFLE和AKIN标准在危重患者中早期开始HD会降低死亡率，我们回顾性评估了医疗ICU中的68例患者的病历并将患者分为两组： ，或根据RIFLE的受伤阶段以及根据AKIN的0，I或II阶段被定义为早期HD，根据RIFLE和根据AKIN处于III阶段的失败阶段被定义为HD晚期。患者的中位年龄为66.5岁，男性为56.5％。在RIFLE和AKIN分类的早期阶段，分别有25％和39.7％的患者开始HD。根据RIFLE的研究，在早期存活的患者中，有61.5％开始进行HD；死者中这一比例为16.4％（P = 0.001）。在AKIN的0，I和II期的69.2％的存活患者和32.7％的死者中开始HD（P = 0.026）。 HD期间败血症（61.5％vs. 94.5％; P = 0.001）和机械通气（30.8％vs. 87.3％; P <0.001）增加ICU死亡率，而根据RIFLE早期进行HD则降低ICU死亡率（61.5％对比16.4％； P = 0.001）。总之，在重症患者中，根据RIFLE分类在早期开始HD可以降低我们的ICU死亡率。

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