| Objective:To explore the diagnostic value of the RIFLE criteria and AKINcriteria for children AKI, in order to contribute to early diagnosis andtreatment of children with AKI.Methods:1328cases of hospitalized children admitted to Children’s HospitalAffiliated to Chongqing Medical University from January1,2011toDecember31,2011with diagnosis of primary and secondary kidneydisease or renal function abnormalities were retrospectively analyzed, theclinical manifestation, laboratory indicators, therapeutics and outcome ofAKI children were collected, followed by statistical analysis withSPSS17.0. To explore the diagnostic value of RIFLE criteria and AKINcriteria for children AKI. Results:1. In the1328cases, only223cases were up to standard for AKI.Among them,222cases were up to the RIFLE standard,223cases were upto the AKIN standard,89cases(39.9%) were up to standard for ARF.2. In the223cases of AKI children,151male(s67.7%)and72females(32.3%)were included；the oldest was16years and2months, theyoungest was1hour and3second, and the median age was3years and9months. In the distribution of prognosis,88cases(39.5%)were cured,80cases(35.9%)were improved,40case(s17.9%)were uncured and15cases(6.7%)died.3. According to the RIFLE criteria,46cases(20.7%)were in riskphase of renal dysfunction,72cases(32.4%)were in injury phase,104cases(46.8%)were in failure phase.4. According to the AKIN criteria,45cases(20.2%)were in stage1,59cases(26.4%)were in stage2,119cases(53.4%)were in stage3.5. Compared to RIFLE criteria, AKIN criteria has no obviousadvantage in the diagnosis of AKI children(χ~2=1，P=0.962).6. In terms of staging diagnosis, there’s no significant statisticaldifference(P>0.05)between the stage1,stage2, stage3in AKIN criteriaand the corresponding risk, injury, failure phase in RIFLE criteria.7. Regardless of the AKIN criteria or RIFLE criteria, the distributionof prognosis，mechanical ventilation rate, blood purification rate, incidencerate of multiple organ dysfunction and acute renal failure(ARF)in different AKI stage are significantly statistically different.8. As the severity of AKI (the stage of AKI) increase, the in-hospitalmortality increase. The in-hospital mortality of children with AKI in failurephase (stage3) was significantly higher than that in risk phase (stage1) andinjury phase (stage2). However, there’s no significant statistical differencein the in-hospital mortality between AKI children in risk phase and injuryphase (stage1and stage2). Moreover, there’s no statistical difference incure rate and average hospitalization days in different AKI stages.Conclusion:The RIFLE criteria and AKIN criteria showed no obvious differencein the diagnosis of AKI children. No significant statistical difference wasfound for the distribution of short-term prognosis between the stage1,stage2, stage3in AKIN criteria and the corresponding risk, damage,failure phase in RIFLE criteria, thus there’s no evidence showed that theshort-term prognosis of AKI children staged according to differentdiagnostic criteria is different. However, Regardless of the AKIN criteria orRIFLE criteria, the distribution of short-term prognosis in different AKIstage are significantly statistically different. The increase of kidney injuryseverity in AKI children (the increase of the stage) is closely related topoor short-term prognosis. As the severity of AKI (the stage of AKI)increase, the mechanical ventilation rate, blood purification rate, incidence rate of multiple organ dysfunction and acute renal failure(ARF)increase.The in-hospital mortality of children with AKI in failure phase (stage3)was significantly higher than that in risk phase (stage1) and injury phase(stage2). However, there’s no statistical difference in cure rate and averagehospitalization days in different AKI stages. After comprehensiveconsideration, it’s recommened to use the AKIN staging criteria for thediagnosis of AKI children because of the higher feasibility in clinicalapplication. |
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