Prevalence of acute kidney injury in medical icu patients according to rifle criteria

We studied the epidemiology and clinical outcome of acute kidney injury among patients admitted to the medical critical care unit of Zagazig University hospitals in a 6 months period, using the RIFLE classification.Based on RIFLE, 21% of admitted patients were identified as AKI patients, with 8.5% classified as (R), 7.9% classified as (I) and 4.6% classified as (F). These results confirm the previously reported findings of several single center and multicenter studies that documented even higher rates of AKI among surgical as well as medical critical care patients.We also confirmed the previous reports of increasing mortality risk with worsening of the RIFLE class, with the worst outcome in patients with class (F). Higher mortality rates were recorded in the elderly male patients, patients with hypoalbuminaemia and in patients with other co-morbidities.Applying serum creatinine criteria in RIFLE classification was associated in our study with higher mortality and poorer outcome compared with classification based on urine output criteria. This finding may point out to the poor sensitivity of serum creatinine as a screening marker for the early detection of acute kidney injury in the ICU settings. Several ICU-related factors may result in decreased creatinine load, which consequently resulted in a lower serum creatinine for a given GFR..