冠状动脉搭桥术后急性肾损伤：使用RIFLE和AKIN标准进行评估
Acute kidney injury after coronary artery bypass grafting: assessment using RIFLE and AKIN criteria.
作者信息
Nina Vinicius José da Silva, Matias Maryanne Miranda, Brito Dyego José de Araújo, Figueiredo Neto José Albuquerque de, Coutinho Léa Barroso, Rodrigues Rayssa Fiterman, Mendes Vinícius Giuliano Gonçalves, Gaspar Shirlyne Fabianni Dias
机构信息
Cardiac Surgery Unit at University Hospital of Maranhão, São Luís, MA, Brazil.
出版信息
Rev Bras Cir Cardiovasc. 2013 Jun;28(2):231-7. doi: 10.5935/1678-9741.20130033.
OBJECTIVE
To compare the RIFLE (Risk, Injury, Failure, Loss and End-stage Renal Failure) and AKIN (Acute Kidney Injury Network) criteria for diagnosis of acute kidney injury after coronary artery bypass grafting.
METHODS
Retrospective cohort. 169 patients who underwent coronary artery bypass grafting from January 2007 through December 2008 were analyzed. Information was entered into a database and analyzed using STATA 9.0.
RESULTS
Patients' mean age was 63.43 1 9.01 years old. Predominantly male patients (66.86%) were studied. Acute Kidney Injury was present in 33.14% by AKIN and in 29.59% by RIFLE. Hemodialysis was required by 3.57% and 4.0% of the patients when AKIN and RIFLE were applied respectively. There was 4.0% and 3.57% mortality of patients with Acute Kidney Injury according to the RIFLE and AKIN criteria, respectively. In 88.76% of the cases, there was good agreement between the two methods in the detection (kappa=0.7380) and stratification (kappa=0.7515) of Acute Kidney Injury.
CONCLUSION
This study showed that the RIFLE and AKIN criteria have a good agreement in the detection and stratification of acute kidney injury after coronary artery bypass grafting.
目的
比较RIFLE（风险、损伤、衰竭、丧失和终末期肾衰竭）和AKIN（急性肾损伤网络）标准在冠状动脉旁路移植术后急性肾损伤诊断中的应用。
方法
回顾性队列研究。分析了2007年1月至2008年12月期间接受冠状动脉旁路移植术的169例患者。信息录入数据库并使用STATA 9.0进行分析。
结果
患者的平均年龄为63.43±9.01岁。主要研究男性患者（66.86%）。根据AKIN标准，急性肾损伤的发生率为33.14%；根据RIFLE标准，发生率为29.59%。分别应用AKIN和RIFLE标准时，需要进行血液透析的患者比例分别为3.57%和4.0%。根据RIFLE和AKIN标准，急性肾损伤患者的死亡率分别为4.0%和3.57%。在88.76%的病例中，两种方法在急性肾损伤的检测（kappa=0.7380）和分层（kappa=0.7515）方面具有良好的一致性。
结论
本研究表明，RIFLE和AKIN标准在冠状动脉旁路移植术后急性肾损伤的检测和分层方面具有良好的一致性。
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