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Abstract
A short-cut review was performed to evaluate whether the RIFLE or AKIN score for acute renal impairment is the best way to determine prognosis. A database search identified 11 relevant publications and the study methods and results were detailed in a table. The clinical bottom line is that both score are as good as predicting death following presentation with acute renal failure.
- Clinical
- diagnosis
- management
- methods
- pulmonary embolism
- respiratory
- thromboembolic disease
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Reported by: Will Bentley, Medical Student
Checked by: Kerstin Hogg, Thrombosis Research Fellow
Institution: Manchester Royal Infirmary, Manchester, UK
Three-part question
In (patients presenting to the emergency department with acute renal failure) is it better to use the (RIFLE or AKIN score) to (predict prognosis)?
Clinical scenario
A 70-year-old woman presents to the emergency department (ED) with confusion and collapse. You find her serum creatinine is 180 μmol/l and wonder which classification system you should use to determine her renal function and prognosis.
Search strategy
Medline 1996 to July week 1 2011 and Embase 1947 to July 2011 using the OVID interface. ((RIFLE.mp) AND (acute kidney injury network.mp OR AKIN.mp)).
Search outcome
The Medline search identified 36 potentially relevant papers and EMBASE identified 65 papers.
Comment
No study has assessed the utility of either score in the ED. Most studies did not apply the urine output criteria, which would be more relevant to the ED population.
Clinical bottom line
Both the RIFLE and AKIN score are predictive of inpatient mortality, and appear to be equally as good.
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