Value of Kidney Disease Improving Global Outcomes Urine Output Criteria in Critically III Patients: A Secondary Analysis of a Multicenter Prospective Cohort Study

被引：13

作者：

Qin, Jun-Ping ^{[1
,2
]}

Yu, Xiang-You ^{[3
]}

Qian, Chuan-Yun ^{[4
,5
]}

Li, Shu-Sheng ^{[6
]}

Qin, Tie-He ^{[7
]}

Chen, Er-Zhen ^{[8
]}

Lin, Jian-Dong ^{[9
]}

Ai, Yu-Hang ^{[10
]}

Wu, Da-Wei ^{[11
]}

Liu, De-Xin ^{[12
]}

Sun, Ren-Hua ^{[13
]}

Hu, Zhen-Jie ^{[14
]}

Cao, Xiang-Yuan ^{[15
]}

Zhou, Fa-Chun ^{[16
]}

He, Zhen-Yang ^{[17
]}

Zhou, Li-Hua ^{[18
]}

An, You-Zhong ^{[19
]}

Kang, Yan ^{[20
]}

Ma, Xiao-Chun ^{[21
]}

Zhao, Ming-Yan ^{[22
]}

Jiang, Li ^{[23
]}

Xu, Yuan ^{[2
]}

Du, Bin ^{[1
]}

机构：

[1] Peking Union Med Coll Hosp, Med Intens Care Unit, 1 Shuai Fu Yuan, Beijing 100730, Peoples R China

[2] Capital Med Univ, Beijing Tongren Hosp, Dept Crit Care Med, Beijing 100730, Peoples R China

[3] Xinjiang Med Univ, Affiliated Hosp 1, Dept Crit Care Med, Urumqi 830054, Xinjiang, Peoples R China

[4] Kunming Med Univ, Affiliated Hosp 1, Dept Emergency Med, Kunming 650032, Yunnan, Peoples R China

[5] Kunming Med Univ, Affiliated Hosp 1, Med Intens Care Unit, Kunming 650032, Yunnan, Peoples R China

[6] Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Crit Care Med, Wuhan 430030, Hubei, Peoples R China

[7] Guangdong Gen Hosp, Dept Crit Care Med, Guangzhou 510080, Guangdong, Peoples R China

[8] Shanghai Jiao Tong Univ, Dept Emergency Med, Shanghai 200025, Peoples R China

[9] Fujian Med Univ, Affiliated Hosp 1, Dept Crit Care Med, Fuzhou 350005, Fujian, Peoples R China

[10] Cent S Univ, Xiangya Hosp, Dept Crit Care Med, Changsha 410008, Hunan, Peoples R China

[11] Shandong Univ, Qilu Hosp, Dept Crit Care Med, Jinan 250012, Shandong, Peoples R China

[12] Jilin Univ, Hosp 2, Dept Emergency & Crit Care Med, Changchun 130041, Jilin, Peoples R China

[13] Zhejiang Prov Peoples Hosp, Dept Crit Care Med, Hangzhou 310014, Zhejiang, Peoples R China

[14] Hebei Med Univ, Hosp 4, Dept Crit Care Med, Shijiazhuang 050011, Hebei, Peoples R China

[15] Ningxia Med Univ, Affiliated Hosp, Dept Crit Care Med, Ningxia 750004, Peoples R China

[16] Chongqing Med Univ, Affiliated Hosp 1, Dept Emergency & Intens Care Med, Chongqing 400016, Peoples R China

[17] Hainan Prov Peoples Hosp, Dept Crit Care Med, Haikou 570311, Hainan, Peoples R China

[18] Inner Mongolia Med Coll, Affiliated Hosp, Dept Crit Care Med, Hohhot 010050, Inner Mongolia, Peoples R China

[19] Peking Univ, Peoples Hosp, Dept Crit Care Med, Beijing 100044, Peoples R China

[20] Sichuan Univ, West China Hosp, Dept Crit Care Med, Chengdu 610041, Sichuan, Peoples R China

[21] China Med Univ, Affiliated Hosp 1, Dept Crit Care Med, Shenyang 110001, Liaoning, Peoples R China

[22] Harbin Med Univ, Affiliated Hosp 1, Dept Crit Care Med, Harbin 150001, Heilongjiang, Peoples R China

[23] Capital Med Univ, Fuxing Hosp, Dept Crit Care Med, Beijing 100038, Peoples R China

来源：

CHINESE MEDICAL JOURNAL | 2016年 / 129卷 / 17期

关键词：

Acute Kidney Injury; Critically III; Mortality; Serum Creatinine; Urine Output; ACUTE-RENAL-FAILURE; INTENSIVE-CARE-UNIT; ILL PATIENTS; RIFLE CRITERIA; CONSENSUS CONFERENCE; ORGAN FAILURE; INJURY; MORTALITY; DEFINITIONS; OLIGURIA;

D O I：

10.4103/0366-6999.189059

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Urine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KDIGO) definition and classification system for acute kidney injury (AKI), of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO(UO) criteria (KDIGO(UO)) could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria (KDIGO(SCr)). Methods: We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a 2-month prospective cohort study (July 1,2009 to August 31,2009) involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGO(UO) and KDIGO(SCr)- Hospital mortality of patients with more severe AKI classification based on KDIGO(UO) was compared with other patients by univariate and multivariate regression analyses. Results: The prevalence of AKI increased from 52.4% based on KDIGO(SCr) to 55.4% based on KDIGO(SCr) combined with KDIGO(UO). KDIGO(UO) also resulted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AKI classification based on KDIGO(UO)- Compared with non-AKI patients or those with maximum AKI classification by KDIGO(SCr), those with maximum AKI classification by KDIGO(UO) had a significantly higher hospital mortality of 58.4% (odds ratio [OR]: 7.580, 95% confidence interval [CI]: 4.141-13.873, P<0.001). In a multivariate logistic regression analysis, AKI based on KDIGO(UO) ( OR: 2.891, 95% CI: 1.964-4.254, P<0.001), but not based on KDIGO(SCr) ( OR: 1.322, 95% CI: 0.902-1.939, P=0.152), was an independent risk factor for hospital mortality. Conclusion: UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.

引用

页码：2050 / 2057

页数：8

共 38 条

[1] Incidence and outcomes in acute kidney injury: A comprehensive population-based study [J].

Ali, Tariq ;

Khan, Izhar ;

Simpson, William ;

Prescott, Gordon ;

Townend, John ;

Smith, William ;

MacLeod, Alison .

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2007, 18 (04) :1292-1298

[2]

[Anonymous], 2012, KIDNEY INT SUPPL, DOI DOI 10.1038/KISUP.2011.32

[3] A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients [J].

Bagshaw, Sean M. ;

George, Carol ;

Bellomo, Rinaldo .

NEPHROLOGY DIALYSIS TRANSPLANTATION, 2008, 23 (05) :1569-1574

[4] A multi-center evaluation of early acute kidney injury in critically ill trauma patients [J].

Bagshaw, Sean M. ;

George, Carol ;

Gibney, R. T. Noel ;

Bellomo, Rinaldo .

RENAL FAILURE, 2008, 30 (06) :581-589

[5] A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients [J].

Bagshaw, Sean M. ;

George, Carol ;

Dinu, Irina ;

Bellomo, Rinaldo .

NEPHROLOGY DIALYSIS TRANSPLANTATION, 2008, 23 (04) :1203-1210

[6] Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group [J].

Bellomo, R ;

Ronco, C ;

Kellum, JA ;

Mehta, RL ;

Palevsky, P .

CRITICAL CARE, 2004, 8 (04) :R204-R212

[7] THE AMERICAN-EUROPEAN CONSENSUS CONFERENCE ON ARDS - DEFINITIONS, MECHANISMS, RELEVANT OUTCOMES, AND CLINICAL-TRIAL COORDINATION [J].

BERNARD, GR ;

ARTIGAS, A ;

BRIGHAM, KL ;

CARLET, J ;

FALKE, K ;

HUDSON, L ;

LAMY, M ;

LEGALL, JR ;

MORRIS, A ;

SPRAGG, R ;

COCHIN, B ;

LANKEN, PN ;

LEEPER, KV ;

MARINI, J ;

MURRAY, JF ;

OPPENHEIMER, L ;

PESENTI, A ;

REID, L ;

RINALDO, J ;

VILLAR, J ;

VANASBECK, BS ;

DHAINAUT, JF ;

MANCEBO, J ;

MATTHAY, M ;

MEYRICK, B ;

PAYEN, D ;

PERRET, C ;

FOWLER, AA ;

SCHALLER, MD ;

HUDSON, LD ;

HYERS, T ;

KNAUS, W ;

MATTHAY, R ;

PINSKY, M ;

BONE, RC ;

BOSKEN, C ;

JOHANSON, WG ;

LEWANDOWSKI, K ;

REPINE, J ;

RODRIGUEZROISIN, R ;

ROUSSOS, C ;

ANTONELLI, MA ;

BELOUCIF, S ;

BIHARI, D ;

BURCHARDI, H ;

LEMAIRE, F ;

MONTRAVERS, P ;

PETTY, TL ;

ROBOTHAM, J ;

ZAPOL, W .

AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 149 (03) :818-824

[8] DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].

BONE, RC ;

BALK, RA ;

CERRA, FB ;

DELLINGER, RP ;

FEIN, AM ;

KNAUS, WA ;

SCHEIN, RMH ;

SIBBALD, WJ .

CHEST, 1992, 101 (06) :1644-1655

[9] Independent association between acute renal failure and mortality following cardiac surgery [J].

Chertow, GM ;

Levy, EM ;

Hammermeister, KE ;

Grover, F ;

Daley, J .

AMERICAN JOURNAL OF MEDICINE, 1998, 104 (04) :343-348

[10] North East Italian Prospective Hospital Renal Outcome Survey on Acute Kidney Injury (NEiPHROS-AKI): Targeting the problem with the RIFLE criteria [J].

Cruz, Dinna N. ;

Bolgan, Irene ;

Perazella, Mark A. ;

Bonello, Monica ;

de Cal, Massimo ;

Corradi, Valentina ;

Polanco, Natalia ;

Ocampo, Catalina ;

Nalesso, Federico ;

Piccinni, Pasquale ;

Ronco, Claudio .

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2007, 2 (03) :418-425

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