A comparison of observed versus estimated baseline creatinine for determination of RIFLE class in patients with acute kidney injury

Sean M Bagshaw, Shigehiko Uchino, Dinna N Cruz, Rinaldo Bellomo, Hiroshi Morimatsu, Stanislao Morgera, Miet R C Schetz, Ian Tan, Catherine S C Bouman, Etienne Macedo, Noel R T Gibney, Ashita J Tolwani, Heleen M Oudemans-van Straaten, Claudio Ronco, John A Kellum

Research output: Contribution to journalArticleResearchpeer-review

156 Citations (Scopus)


The RIFLE classification scheme for acute kidney injury (AKI) is based on relative changes in serum creatinine (SCr) and on urine output. The SCr criteria, therefore, require a pre-morbid baseline value. When unknown, current recommendations are to estimate a baseline SCr by the MDRD equation. However, the MDRD approach assumes a glomerular filtration rate of 75 mLmin1.73 m2. This method has not been validated.Methods. Data from the Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) study, a prospective observational study from 54 ICUs in 23 countries of critically ill patients with severe AKI, were analysed. The RIFLE class was determined by using observed (o) pre-morbid and estimated (e) baseline SCr values. Agreement was evaluated by correlation coefficients and Bland-Altman plots. Sensitivity analysis by chronic kidney disease (CKD) status was performed
Original languageEnglish
Pages (from-to)2739 - 2744
Number of pages6
JournalNephrology Dialysis Transplantation
Issue number9
Publication statusPublished - 2009
Externally publishedYes

Cite this