• Ebtesam M Kamal, Manal M El Behery, Gamal Abbas El Sayed, and Howaida K Abdulatif.
• Department of Obstetrics & Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
• Reprod Sci. 2014 Oct 1;21(10):1281-7.

ObjectiveThis study is to assess the correlation of risk, injury, failure, loss, and end-stage renal failure (RIFLE) classification with hospital mortality in intensive care unit (ICU) obstetric patients and to evaluate the relation of acute kidney injury (AKI) to other risk factors.MethodsThe 4 stages of RIFLE (nonacute renal failure, risk, injury, and failure) were scored from 0 to 3 points, respectively. The prognostic performance of the RIFLE score was compared to the general ICU models.ResultsAKI occurred in 30 (5.88%) of patients admitted to ICU. The main causes of AKI were hemolysis, elevated liver enzymes, and low platelet syndrome 13 (43%), pregnancy-related hypertension 9 (30%), puerperal sepsis 3 (10%), abruption placentae 2 (6.6%), disseminated intravascular coagulopathy 2 (6.6%), and anesthetic complications 1 (3.3%). According to the RIFLE criteria, patients were classified into Risk (3.3%), Injury (16.6%), Failure (33.3%), and Loss (46.6%). Maternal mortality from total ICU admission occurred in 51 (10%) cases, of these 16 (31.3%) cases were due to AKI. Independent risk factors associated with mortality were hyperbilirubinemia, low levels of HCO3, and RIFLE. Receiver-operator characteristic curves for ICU patients according to RIFLE score showed area under the curve = 0.824.ConclusionThe RIFLE classification system could predict the risk of mortality from AKI in obstetric ICU patients and mortality was positively associated with high RIFLE classes.© The Author(s) 2014.

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