- The same group of patients in the above study were used to establish
and validate the pRIFLE classification scheme in another article4:
risk=CrCl 25%, injury=CrCl 50%; failure CrCl 75% or < 35mL/min/1.73m<;
loss > 4wks duration; end stage > 3 months duration.2
- The same group was also used to examine the role of urinary NGAL and
AKI, which found that it may be a good predictor of the onset of AKI,
but not the severity. Although they examined the relationship with PRISM
II scores, they did not adjust for them in their analysis, and so the
confounding nature of illness severity could not be reliably assessed.3
- It is more likely that a panel of serum and urine tests, including
S/U-NGAL, UIL-18, serum cystatin C, and UKIM-1, which are sequentially
expressed at various stages of AKI, will emerge as useful for timing
the initial insult, assessing the duration/severity, and differentiating
between the types of etiologies of AKI, but we are still a ways off
before this enters the realm of clinical usefulness.2
KK, et al. Urinary interleukin-18 is an acute kidney injury biomarker
in critically ill children. Nephrol Dial Transplant 2008;23:566-72.
MT, et al. Biomarkers for early detection of acute kidney injury. Pediatr
M, et al. Urine neutrophil gelatinase-associated lipocalin is an early
marker of acute kidney injury in critically ill children: a prospective
cohort study. Critical Care. 2007.
A, et al. Modified RIFLE criteria in critically ill children with acute
kidney injury. Kidney International. 2007;71:1028-35.