2018 Volume 9 Issue 1 Pages 18-22
There may be a mismatch in the severity of acute kidney injury (AKI) depending on different criteria. We investigated serum creatinine (sCr) level and urine output in accordance with the Kidney Disease Improving Global Outcomes (KDIGO) classification. Mismatch cases were identified among patients with septic shock who were transported to the Advanced Emergency Medical Service Center, Kurume University Hospital between January 2014 and March 2016. The sCr criteria diagnosed 26 patients with more severe AKI (sCr group), and the urine output criteria diagnosed 20 patients with more severe AKI. The two groups were compared in terms of clinical severity and patient outcomes. There was no significant difference in clinical severity between the groups. However, urine output from day 1 to day 3 in the sCr and urine output groups were 1,600±1,400 vs 530±440mL/day, 1,010±1,080 vs 320±390mL/day, and 980±720 vs 430±380mL/day, respectively, indicating significantly lower urine output in the urine output group. In addition, there were significantly more fatalities in the urine output group (8/20) than in the sCr group (3/26). These results suggest that, with similar clinical severity, poorer outcomes at the time of discharge from the intensive care unit might be more common in patients with urine output criteria indicating higher severity of AKI.
