Tianxin Chen1, Xiaokai Ding, Bo Chen. 1. Department of Nephrology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou Medical College, Wenzhou 325000, China. ctxzjf@163.com
Abstract
BACKGROUND: There are many studies on the RIFLE classification to evaluate the occurrence rate and/or outcome of acute kidney injury (AKI) in ICU patients, but there are no studies on the RIFLE classification to evaluate the outcome of AKI in lupus patients. METHODS: This retrospective study analysed the short-term outcomes of 79 diffuse proliferative lupus nephritis patients according to the RIFLE classification. RESULTS: A total of 46% of patients were No AKI, 23% AKI-R, 16% AKI-I and 15% AKI-F according to the maximum RIFLE class reached on the first day of admission. The percentage of progression of AKI to the more severe RIFLE class was 6% for AKI-R, 23% for AKI-I and 75% for AKI-F (P < 0.0001), and there was an increased odds ratio (OR) of progression rate with more severe RIFLE category (OR 7.7, 95% CI 2.3-25.7, P < 0.001). The recovery rate at the end of a 24-week follow-up was 100% for AKI-R, 92% for AKI-I and 33% for AKI-F (P < 0.0001). The mean time to recovery for the groups AKI-R, AKI-I and AKI-F was 4, 11 and 20 weeks, respectively (P < 0.0001). The area under the ROC curve for progression to chronic kidney disease (CKD) was 0.96 (95% CI 0.91-1.0, P < 0.001). CONCLUSION: The RIFLE classification is predictive of progression and short-term prognosis of AKI in diffuse proliferative lupus nephritis.
BACKGROUND: There are many studies on the RIFLE classification to evaluate the occurrence rate and/or outcome of acute kidney injury (AKI) in ICU patients, but there are no studies on the RIFLE classification to evaluate the outcome of AKI in lupuspatients. METHODS: This retrospective study analysed the short-term outcomes of 79 diffuse proliferative lupus nephritispatients according to the RIFLE classification. RESULTS: A total of 46% of patients were No AKI, 23% AKI-R, 16% AKI-I and 15% AKI-F according to the maximum RIFLE class reached on the first day of admission. The percentage of progression of AKI to the more severe RIFLE class was 6% for AKI-R, 23% for AKI-I and 75% for AKI-F (P < 0.0001), and there was an increased odds ratio (OR) of progression rate with more severe RIFLE category (OR 7.7, 95% CI 2.3-25.7, P < 0.001). The recovery rate at the end of a 24-week follow-up was 100% for AKI-R, 92% for AKI-I and 33% for AKI-F (P < 0.0001). The mean time to recovery for the groups AKI-R, AKI-I and AKI-F was 4, 11 and 20 weeks, respectively (P < 0.0001). The area under the ROC curve for progression to chronic kidney disease (CKD) was 0.96 (95% CI 0.91-1.0, P < 0.001). CONCLUSION: The RIFLE classification is predictive of progression and short-term prognosis of AKI in diffuse proliferative lupus nephritis.
Authors: Brian R Stotter; Ellen Cody; Hongjie Gu; Ankana Daga; Larry A Greenbaum; Minh Dien Duong; Alexandra Mazo; Beatrice Goilav; Alexis Boneparth; Mahmoud Kallash; Ahmed Zeid; Wacharee Seeherunvong; Rebecca R Scobell; Issa Alhamoud; Caitlin E Carter; Siddharth Shah; Caroline E Straatmann; Bradley P Dixon; Jennifer C Cooper; Raoul D Nelson; Deborah M Levy; Hermine I Brunner; Priya S Verghese; Scott E Wenderfer Journal: Pediatr Nephrol Date: 2022-10-17 Impact factor: 3.651