Department of Medical Intensive Care, Service de Réanimation Médicale, CHU de Caen, Av Côte de Nacre, 14000 Caen, France.
J Crit Care. 2013 Apr;28(2):116-25. doi: 10.1016/j.jcrc.2012.06.012. Epub 2012 Sep 13.
The lack of a consensus definition for acute kidney injury (AKI) has led to a great deal of discrepancies and confusion in the literature in this field. Thus, the RIFLE (Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function and End-stage renal disease) and Acute Kidney Injury Network (AKIN) classifications were developed by multidisciplinary collaborative groups and were validated by experts in an international consensus conference in 2007 under an umbrella "acute kidney insufficiency" definition.
Search in the MEDLINE and PUBMED databases for relevant literature from January 2000 to June 2011 was performed to assess the accuracy of the novel consensus definitions for AKI.
Both systems are based on serum creatinine level and urine output criteria and are staged in 3 severity levels. A major difference between these 2 classifications is that smaller and more rapid changes in serum creatinine are considered in the AKIN stage 1. Each AKI classification has demonstrated its ability to stratify patients according to their AKI severity and to predict outcomes. No classification system has been shown to be superior over the others. Their application in clinical studies would benefit from standardization and the new Kidney Disease Improving Global Outcomes definition of AKI was recently proposed to achieve this aim. Because these classifications do not allow earlier AKI diagnosis and do not optimize the timing of RRT initiation, they remain of moderate utility from the patient's point of view.
急性肾损伤（AKI）缺乏共识定义，导致该领域文献中存在大量差异和混淆。因此，风险、损伤、衰竭、丧失和终末期肾病（RIFLE）和急性肾损伤网络（AKIN）分类由多学科协作组制定，并在 2007 年由国际共识会议的专家在“急性肾损伤不足”定义下进行了验证。
在 MEDLINE 和 PUBMED 数据库中搜索 2000 年 1 月至 2011 年 6 月的相关文献，以评估 AKI 新共识定义的准确性。
这两个系统均基于血清肌酐水平和尿量标准，并分为 3 个严重程度级别。这两个分类的一个主要区别在于 AKIN 分期 1 中考虑了较小和更快的血清肌酐变化。每种 AKI 分类都已证明其能够根据 AKI 严重程度对患者进行分层，并预测结局。没有一种分类系统被证明优于其他系统。它们在临床研究中的应用将受益于标准化，最近提出了肾脏病改善全球结局（KDIGO）的 AKI 新定义以实现这一目标。由于这些分类法不能更早地诊断 AKI，也不能优化开始肾脏替代治疗的时机，因此从患者的角度来看，它们的应用价值仍然有限。
