Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study

Yun Ji, Libin Li Department of Surgical Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, People’s Republic of ChinaCorrespondence: Yun JiDepartment of Surgical Intensive Care Unit, The Second Affiliated Hospital, School of Medi...

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Autores principales:	Ji Y, Li L
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	acute kidney injury critical care critically ill patients kidney disease: improving global outcomes mortality Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/313f4c1fed634a8696e6bc5e34c06f86
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spelling	oai:doaj.org-article:313f4c1fed634a8696e6bc5e34c06f862021-11-09T18:40:34ZPrognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study1178-7074https://doaj.org/article/313f4c1fed634a8696e6bc5e34c06f862021-11-01T00:00:00Zhttps://www.dovepress.com/prognostic-implications-of-a-cumulative-renal-score-based-on-both-seru-peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Yun Ji, Libin Li Department of Surgical Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, People’s Republic of ChinaCorrespondence: Yun JiDepartment of Surgical Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, People’s Republic of ChinaTel +8615805817268Email yunji@zju.edu.cnPurpose: Traditionally, the Kidney Disease: Improving Global Outcomes (KDIGO) stages acute kidney injury (AKI) into three stages based on the highest severity of increase in serum creatinine (SC) or urine output (UO) criteria. Clinically, however, the two criteria do not provide equivalent information. Thus, we aimed to develop a cumulative renal score (the sum of the highest KDIGO SC and UO severity stages) for staging of AKI, expanding the original three KDIGO stages to six stages. We hypothesized that the cumulative renal score would more accurately describe AKI severity and outcomes.Patients and Methods: Critically ill adult patients were identified from the Multi-parameter Intelligent Monitoring in Intensive Care III Database. The primary outcome was hospital mortality. Logistic regression was used to explore the association between cumulative renal score and hospital mortality.Results: A total of 17,404 critically ill adult patients were enrolled. Patients with higher cumulative renal scores had greater hospital mortality than patients with lower cumulative renal scores (score 0, 7.6%; score 1, 9.3%; score 2, 12.5%; score 3, 18.9%; score 4, 27.1%; score 5, 34.7%; score 6, 46.8%, p < 0.001). After adjustment for significant covariates, relative to cumulative renal score 0, cumulative renal scores 2– 6 were associated with increased hospital mortality. Within the traditional KDIGO stage 2 AKI, when compared with cumulative renal score 2, cumulative renal score 4 had increased hospital mortality. Within the traditional KDIGO stage 3 AKI, when compared with cumulative renal score 3, cumulative renal score 6 had increased hospital mortality.Conclusion: Our study demonstrates that the KDIGO SC and UO criteria have a cumulative effect on AKI severity staging. The cumulative renal score improves the traditional KDIGO AKI staging by applying the two sets of criteria sequentially and provides more insight into the relationship between AKI and outcomes.Keywords: acute kidney injury, critical care, critically ill patients, Kidney Disease: Improving Global Outcomes, mortalityJi YLi LDove Medical Pressarticleacute kidney injurycritical carecritically ill patientskidney disease: improving global outcomesmortalityMedicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 7833-7841 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute kidney injury critical care critically ill patients kidney disease: improving global outcomes mortality Medicine (General) R5-920
spellingShingle	acute kidney injury critical care critically ill patients kidney disease: improving global outcomes mortality Medicine (General) R5-920 Ji Y Li L Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study
description	Yun Ji, Libin Li Department of Surgical Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, People’s Republic of ChinaCorrespondence: Yun JiDepartment of Surgical Intensive Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, People’s Republic of ChinaTel +8615805817268Email yunji@zju.edu.cnPurpose: Traditionally, the Kidney Disease: Improving Global Outcomes (KDIGO) stages acute kidney injury (AKI) into three stages based on the highest severity of increase in serum creatinine (SC) or urine output (UO) criteria. Clinically, however, the two criteria do not provide equivalent information. Thus, we aimed to develop a cumulative renal score (the sum of the highest KDIGO SC and UO severity stages) for staging of AKI, expanding the original three KDIGO stages to six stages. We hypothesized that the cumulative renal score would more accurately describe AKI severity and outcomes.Patients and Methods: Critically ill adult patients were identified from the Multi-parameter Intelligent Monitoring in Intensive Care III Database. The primary outcome was hospital mortality. Logistic regression was used to explore the association between cumulative renal score and hospital mortality.Results: A total of 17,404 critically ill adult patients were enrolled. Patients with higher cumulative renal scores had greater hospital mortality than patients with lower cumulative renal scores (score 0, 7.6%; score 1, 9.3%; score 2, 12.5%; score 3, 18.9%; score 4, 27.1%; score 5, 34.7%; score 6, 46.8%, p < 0.001). After adjustment for significant covariates, relative to cumulative renal score 0, cumulative renal scores 2– 6 were associated with increased hospital mortality. Within the traditional KDIGO stage 2 AKI, when compared with cumulative renal score 2, cumulative renal score 4 had increased hospital mortality. Within the traditional KDIGO stage 3 AKI, when compared with cumulative renal score 3, cumulative renal score 6 had increased hospital mortality.Conclusion: Our study demonstrates that the KDIGO SC and UO criteria have a cumulative effect on AKI severity staging. The cumulative renal score improves the traditional KDIGO AKI staging by applying the two sets of criteria sequentially and provides more insight into the relationship between AKI and outcomes.Keywords: acute kidney injury, critical care, critically ill patients, Kidney Disease: Improving Global Outcomes, mortality
format	article
author	Ji Y Li L
author_facet	Ji Y Li L
author_sort	Ji Y
title	Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study
title_short	Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study
title_full	Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study
title_fullStr	Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study
title_full_unstemmed	Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study
title_sort	prognostic implications of a cumulative renal score based on both serum creatinine and urine output criteria for staging of acute kidney injury: a cohort study
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/313f4c1fed634a8696e6bc5e34c06f86
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Prognostic Implications of a Cumulative Renal Score Based on Both Serum Creatinine and Urine Output Criteria for Staging of Acute Kidney Injury: A Cohort Study

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