An assessment of the RIFLE criteria for acute renal failure in critically ill HIV-infected patients.

Acute renal failure is common among hospitalized patients with HIV infection, particularly in the intensive care unit (ICU) setting, and increases mortality. Recently, the Acute Dialysis and Quality Initiative (ADQI) group [1] formulated a new classification for acute renal failure -the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) classificationthat defines three grades of severity -class R (risk), class F (failure), and class I (injury) -and two outcome classes -loss and end-stage kidney disease. Some studies [2,3] have applied the RIFLE criteria in hospitalized patients, particularly in ICU patients, but the clinical ability of these criteria to predict outcome of ICU HIV-infected patients has not yet been assessed. We sought to evaluate retrospectively the ability of the RIFLE criteria (Table Chronic kidney disease patients receiving dialysis were excluded from the analysis. Mortality was assessed at day 60 We evaluated 97 HIV-infected patients (mean age 42.7 12.2 years; 77 male, 69 Caucasian). According to RIFLE, 46 patients (47.4%; mean age 43.2 11.08 years, P = not significant; 39 male, P = not significant; 28 Caucasian, P = not significant) had some degree of acute renal dysfunction. Of these, 12 patients (26%) were class R, 9 patients (19.5%) were class I, and 25 patients (54.3%) were class F; these patients did not differ in terms of age, gender, race, type of HIV, stage of HIV infection, highly active antiretroviral therapy (HAART), comorbidity, and severity of illness. In all cases, maximum RIFLE occurred within the first week of hospitalization.