THE ROLE OF RISK OF RENAL FAILURE, INJURY TO THE KIDNEY, FAILURE OF KIDNEY FUNCTION, LOSS OF KIDNEY FUNCTION AND ENDSTAGE RENAL FAILURE (RIFLE) CLASSIFICATION IN IDENTIFICATION AND PREDICTION SEVERITY OF THE KIDNEY INJURY IN NEWBORNS

Abstract

Objective: Acute kidney injury is a serious condition with various clinical manifestations ranging from minimal kidneys disordsers to kidney injury requiring substitution therapy. Because of need of timely diagnosis of kidney injury, RIFLE classification could be used. The aim of the study was to determine the role of RIFLE classification in detecting and follow up the progression of kidney injury in newborns. Methods: This study was realized at University Clinic of Pediatrics in Skopje from period of two years. It was analyzed the medical records of 80 newborns (40 with kidney injury and 40 without kidney injury) treated in intensive care unit. The severity of the disease was determined by RIFLE classification. Results: During the study period 6.25% of newborns have developed acute kidney injury acording standard clasification. Most of the newborns analyzed in the study were male (66 and 59%) and term (67% and 61%). RIFLE classification was applied in this study. We reported “risk” in 32%, “injury” in 57% and “failure” in 11% of newborns with AKI. Of these, 69% showed progression to “injury “and 15% to “failure”. In 17% of newborns with verified “injury” the condition progressed to “failure”. Conclusion: By using RIFLE classification we could not only identify kidney injury, but also detected the progression of the disease. Hence the significance of this classification as a solid tool in the diagnosis and follow-up of kidney injury in newborns.