Published in:
01-06-2009 | Letter
RIFLE is not RIFLE: on the comparability of results
Published in: Critical Care | Issue 6/2009
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In the consensus RIFLE criteria [1] of acute kidney injury (AKI) the thresholds given for serum creatinine (sCr) increase and glomerular filtration rate (GFR) decrease (Table 1) do not correspond [2]. Direct measurement of GFR in clinical practice is difficult, and values are more often estimated (eGFR) by the Cockroft-Gault equation or the Modification of Diet in Renal Disease (MDRD) formula. In addition, there is controversy in the literature whether eGFR provides more clinical information regarding AKI than changes in sCr [3].
Table 1
RIFLE criteria for the definition of acute kidney injury (urinary output criteria not listed)
|
RIFLE class
|
RIFLE criteria
|
|---|---|
|
R (risk)
|
≥ 1.5-fold increase in serum creatinine, or >25% decrease in GFR
|
|
I (injury)
|
≥ 2-fold increase in serum creatinine, or >50% decrease in GFR
|
|
F (failure)
|
≥ 3-fold increase in serum creatinine, or >75% decrease in GFR
|