Acute kidney injury after infant cardiac surgery: a comparison of pRIFLE, KDIGO, and pROCK definitions

BMC Nephrology

Research

Peng Gao¹  Wang He²  Wenting Wang²  Chun Zhou²  Yu Jin²  Jinping Liu²  Peiyao Zhang²  Jinxiao Hu² 

[1] Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Pediatric Cardiac Surgery Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Fuwai Hospital, No.167, North Lishi Road, Xicheng District, Beijing, China;

关键词: Acute kidney injury;    Pediatric cardiac surgery;    Infants;    KDIGO;    pROCK;    pRIFLE;   

DOI  :  10.1186/s12882-023-03306-y

 received in 2022-09-15, accepted in 2023-08-21,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundKDIGO and pRIFLE classifications are commonly used in pediatric acute kidney injury (AKI). As a novel AKI definition, pROCK considered the high variability of serum creatinine in children. This study aimed to compare the above three definitions for AKI in infants undergoing cardiac surgery.MethodsWe analyzed a clinical cohort of 413 infants undergoing cardiac surgery. AKI was defined and staged according to pRIFLE, KDIGO, and pROCK, respectively. Incidence differences and diagnostic agreement across definitions were assessed. The association between postoperative outcomes and AKI by each definition was investigated.ResultsPostoperative AKI was identified in 185 (44.8%), 160 (38.7%), and 77 (18.6%) patients according to pRIFLE, KDIGO, and pROCK, respectively. The agreement between pRIFLE and KDIGO was almost perfect (κ = 0.88), while there was only a slight agreement between pROCK and them. AKI by pROCK was independently associated with adverse outcomes (p = 0.003) and prolonged mechanical ventilation (p = 0.002).ConclusionsThere were considerable differences in AKI incidence and staging among definitions. Compared with pRIFLE and KDIGO, AKI defined by pROCK was significantly reduced and better associated with postoperative adverse outcomes.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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