Abstract:
:We report the stepwise application of the RIFLE classification in 155,624 admissions in the UK Intensive Care National Audit & Research Centre Case Mix Programme database. The assumptions required to define RIFLE and their relationship with renal replacement therapy (RRT) and ICU mortality were assessed. Previous reports had not explored the method of estimating baseline creatinine, the position of class boundaries, or interactions between urine volume (AKI-U) and the peak/estimated baseline creatinine (AKI-Cr) within 24 h of ICU admission. The risk of developing AKI strongly depended on the assumed GFR increasing from 36 to 58% across the recommended range. AKI-U was often seen without AKI-Cr, and moderate oliguria (under 850 ml/24 h) was a stronger predictor of mortality than any degree of AKI-Cr partly because mortality fell when peak/estimated baseline creatinine ratios exceed fourfold. Mild oliguria (850-1500 ml/24 h) was common (38,928 admissions, 26%) and had a similar association with mortality (relative risk 1.6, 95% CI: 1.5-1.6) as did AKI-Cr defined Failure (risk ratio 1.5, 95% CI: 1.5-1.6). However, AKI-Cr was a strong predictor for RRT, which was used in 17,802 (11%) of admissions. Nearly half (48%) of the Failure patients never received RRT; nonetheless, most (66%) survived critical care. Thus, although the RIFLE classification may be attempted in large population cohorts, there is significant heterogeneity of both renal and, in particular, vital outcomes within each class.
journal_name
Kidney Intjournal_title
Kidney internationalauthors
Harris SK,Lewington AJ,Harrison DA,Rowan KMdoi
10.1038/ki.2015.70subject
Has Abstractpub_date
2015-08-01 00:00:00pages
369-77issue
2eissn
0085-2538issn
1523-1755pii
S2157-1716(15)32185-7journal_volume
88pub_type
杂志文章abstract:BACKGROUND:Chronic inflammation and oxidative stress are highly prevalent in patients with chronic kidney disease and end-stage renal disease (ESRD). These conditions contribute to high mortality rates associated with cardiovascular disease, the leading cause of death in this patient population. To our knowledge, no pr...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2004.00656.x
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Dialysis efficiency has a great influence on the outcome of patients. Few data are available on the removal of solutes with molecular weights higher than urea and creatinine. The aim of our study was to assess the transport and the removal of substances with molecular weights up to 15 kD and to evaluate the ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2002.00216.x
更新日期:2002-03-01 00:00:00
abstract::The purpose of this investigation is to analyze changes in plasma 1,25-(OH)2D and 24,25-(OH)2D after successful renal transplantation in 20 children and young adults. Studies were performed on 8 subjects between the 1st and 10th month and on 12 others between the 20th and 30th to 36th month. Samples were assayed for p...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1981.153
更新日期:1981-09-01 00:00:00
abstract::Albuminuria and a reduced glomerular filtration rate are conventional predictors of a future decline in kidney function in patients with type 2 diabetes mellitus. Using a nested case-control study we assessed whether circulating transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein-7 (BMP-7) levels mor...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2012.383
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Random, nontimed blood pressure (BP) measurements in the outpatient clinic may fail to provide reliable information on actual daily BP control in renal patients on chronic antihypertensive therapy. METHODS:In a cohort of 163 patients with proteinuric chronic nephropathies followed prospectively with repeate...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.2000.00382.x
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:Hemodialysis access thrombosis is a significant cause of morbidity for hemodialysis patients and results from decreased access flow caused by venous outflow tract stenosis. Ultrasound dilution (UD) is a practical, noninvasive, and reliable indicator of access flow and is effective in predicting venous stenos...
journal_title:Kidney international
pub_type: 临床试验,杂志文章
doi:10.1046/j.1523-1755.2001.00753.x
更新日期:2001-06-01 00:00:00
abstract::Both single-frequency bioimpedance and multiple-frequency spectroscopy are equally accurate in measuring total-body water and intracellular fluid. Estimates are consistent at a population level but not at the individual level, because of wide limits of agreement. There is no real 'gold standard' method providing estim...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2013.434
更新日期:2014-04-01 00:00:00
abstract::Nephrons possess a segmental organization where each segment is specialized for the secretion and reabsorption of particular solutes. The developmental control of nephron segment patterning remains one of the enigmas within the field of renal biology. Achieving an understanding of the mechanisms that direct nephron se...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1038/ki.2008.37
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Nitric oxide (NO) has been shown to be a paracrine/autocrine regulator of proximal tubular transport. In this study, we investigated the effect of NO on the paracellular permeability of opossum kidney (OK) cells, a proximal tubule cell line that possesses a leaky paracellular pathway resembling that of the i...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1999.00465.x
更新日期:1999-06-01 00:00:00
abstract::Compared to normal tissue, hyperplastic parathyroid glands of patients with chronic kidney disease on dialysis express lower levels of FGFR1 and Klotho proteins. Similar findings are reported in uremic rats with advanced chronic kidney disease. Moreover, in these animals, FGF23 administration fails to reduce PTH serum...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2009.512
更新日期:2010-03-01 00:00:00
abstract::Renal stone disease, which affects 12% of males and 5% of females by the seventh decade, occurs as an inherited disorder in 45% of patients and is most commonly associated with hypercalciuria. The biochemical basis for hereditary nephrolithiasis and hypercalciuria is unknown, and this has therefore been investigated b...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1046/j.1523-1755.2000.00916.x
更新日期:2000-03-01 00:00:00
abstract::Macrophages are inflammatory cells with important roles in the propagation of renal injury. More recently they have also been shown to be important in the resolution of inflammation. Wang et al. show that macrophages can be modulated ex vivo by cytokine stimulation, localize to renal tissue, and slow progression of ex...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/sj.ki.5002332
更新日期:2007-08-01 00:00:00
abstract::The molecular mechanism of Na+ and phosphate transport by the intestinal brush border membrane Na+/phosphate cotransporter was examined using anion and cation exchange columns interfaced to a light-activated microsecond timer. The nature of ion:cotransporter interaction was examined for sensitivity to itself versus no...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1996.141
更新日期:1996-04-01 00:00:00
abstract::Bone-derived fibroblast growth factor-23 (FGF23) plays an important role in systemic phosphate turnover. Increased FGF23 activity results in hypophosphatemic disorders, while reduced activity is linked to hyperphosphatemic disorders. FGF23, together with klotho as co-factor, can activate FGF receptors in its target ti...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2014.316
更新日期:2014-12-01 00:00:00
abstract::Atrial natriuretic peptide (ANP) is known to suppress platelet-derived growth factor (PDGF)-stimulated proliferation of rat cultured vascular smooth muscle cells. The present study examined whether ANP inhibits the PDGF receptor (PDGFR) tyrosine kinase activation, an initial event for PDGF cellular signaling. ANP redu...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1997.341
更新日期:1997-08-01 00:00:00
abstract::Kidney fibrosis is one of the most promising treatment targets in nephrology. To design effective treatment approaches, a detailed understanding of the initiating mechanisms is of great importance. Kim and Pandanilam now find that renal nerves are a major trigger for renal fibrosis. Both afferent and efferent nerve fi...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2014.327
更新日期:2015-02-01 00:00:00
abstract::In recent times, therapy for renal anemia has changed dramatically in that iron administration has increased and doses of erythropoiesis-stimulating agents (ESAs) have decreased. Here we used a prospective, observational, multicenter design and measured the serum ferritin and hemoglobin levels every 3 months for 2 yea...
journal_title:Kidney international
pub_type: 杂志文章,多中心研究
doi:10.1038/ki.2014.114
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Although several kinds of evidence suggest that glycosaminoglycans (GAGs) and proteoglycans (PGs) may contribute to the development of beta2-microglobulin-related (Abeta2m) amyloidosis, the precise roles of these molecules for the development of Abeta2m amyloidosis are poorly understood. METHODS:We investig...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.2003.00167.x
更新日期:2003-09-01 00:00:00
abstract::The association between dietary sodium and potassium intake with the development of kidney disease remains unclear, particularly among younger individuals. Here, we determined whether dietary sodium and potassium intake are associated with incident chronic kidney disease (CKD) using data from 1,030 adults (age 23-35 i...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2020.02.037
更新日期:2020-07-01 00:00:00
abstract::Nitric oxide is synthesized in experimental immune complex glomerulonephritis due to local induction of type 2 nitric oxide synthase (NOS2). To determine the role of NOS2, the course of accelerated anti-glomerular basement membrane glomerulonephritis (anti-GBM) was examined in mice homozygous for disruption of the NOS...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1111/j.1523-1755.1998.00892.x
更新日期:1998-04-01 00:00:00
abstract::Since 1992 and the discovery of an MIP (major intrinsic protein of lens fiber cell) homologue protein that selectively permeates water, aquaporin (AQP), there has been an explosion of research in this field. Early research speculated that aquaporins played indispensible physiological roles in bacteria and plants, as w...
journal_title:Kidney international
pub_type: 杂志文章,评审
doi:10.1046/j.1523-1755.1998.00123.x
更新日期:1998-10-01 00:00:00
abstract::Platelet activating factor (PAF) is a potent lipid mediator with a broad range of biologic activities. Experimental evidence suggests that PAF plays a role in the pathogenesis of a variety of inflammatory processes including allograft rejection. In this study, we evaluated the effects of the PAF antagonist BN52021 on ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1995.301
更新日期:1995-08-01 00:00:00
abstract::Treatment of mesangial cells with recombinant human interleukin 1 beta (IL-1 beta) triggers the expression of a macrophage-type of nitric oxide (NO) synthase and the subsequent increase of cellular concentration of cGMP and nitrite production. Tetrahydrobiopterin (BH4) is an essential cofactor for NO synthase, and in ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1994.398
更新日期:1994-11-01 00:00:00
abstract::Fatal vascular access hemorrhage is considered a rare complication of hemodialysis (HD). Ellingson et al. indicate otherwise, and their data suggest that it causes 0.4-1.6% of deaths in US HD patients. It is more common with grafts than fistulas, and many victims have had previous access hemorrhages. The widespread pr...
journal_title:Kidney international
pub_type: 评论,杂志文章
doi:10.1038/ki.2012.181
更新日期:2012-09-01 00:00:00
abstract::Spontaneous and aspirated blood samples were collected from the welling points of surface efferent arterioles in the rat kidney. The amount of tubular reabsorbate in each sample was calculated from measurements of the inulin concentration in the sample and systemic arterial plasma. Both spontaneous and aspirated sampl...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1984.44
更新日期:1984-03-01 00:00:00
abstract::From August 1987 through February 1995 we performed 42 surgical procedures in 29 patients with occluded or stenotic radiocephalic arteriovenous fistulae. Operations were designed to preserve native veins for cannulation (Group I) or to preserve access in the same forearm, bypassing the failed fistula (Group II). For 2...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1046/j.1523-1755.1998.00769.x
更新日期:1998-02-01 00:00:00
abstract::Alterations in myocardial wall texture stand out among ADPKD cardiovascular manifestations in hypertensive and normotensive patients. To elucidate their pathogenesis, we analyzed the cardiac phenotype in Pkd1(cond/cond)Nestin(cre) (CYG+) cystic mice exposed to increased blood pressure, at 5 to 6 and 20 to 24 weeks of ...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1016/j.kint.2016.04.028
更新日期:2016-09-01 00:00:00
abstract::Experiments were performed to study the mechanism of the compensatory increase in the excretion of metabolic acid by residual nephrons after reduction in renal mass. Despite a decrease in nephron population to 20% of control, total excretion of acid remained similar to pair-fed controls due to an increase in nephron e...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1980.70
更新日期:1980-05-01 00:00:00
abstract::Levels of components of the classical and alternative complement pathways and the activity of the C3 nephritic factor (C3NeF) were measured in serum specimens from patients with type I (subendothelial deposits) and type II (intramembranous dense deposits) membranoproliferative glomerulonephritis (MPGN) and the results...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.1976.6
更新日期:1976-01-01 00:00:00
abstract::Angiotensin II plays an important role in the regulation of blood pressure, body salt and fluid balance, and urine concentration. Mice with deletion of the AT(1a) receptor develop polyuria and urine concentration defects. We studied the mechanisms of these urine concentration defects by treating wild-type and AT(1a)-k...
journal_title:Kidney international
pub_type: 杂志文章
doi:10.1038/ki.2009.134
更新日期:2009-07-01 00:00:00