014), cardiac failure (P = 0.005), selleck chem sepsis before RRT (P = 0.002), length of hospital stay (P = 0.025), and the period from ICU and RRT to death or discharge (P = 0.005 and < 0.001 respectively). GCS (P = 0.040) and APACHE II scores (P = 0.010) at ICU admission, and pre-RRT platelet count (P = 0.027), BUN (P = 0.016), GCS (P < 0.001), APACHE II scores (P < 0.001), SOFA scores (P = 0.005), as well as the percentage of LD (P = 0.002) and RRT wean-off rate (P < 0.001) were also statistically different. Other comorbid diseases, clinical parameters, and usage of diuretics or vasopressors were not statistically significant as compared between these two groups.Using the backward stepwise likelihood ratio model of Cox proportional hazard method for in-hospital mortality, LD (hazard ratio (HR) 1.

846; 95% confidence interval (CI) 1.071-3.182; P = 0.027), old age (older than 65 years) (HR 2.090; 95% CI 1.196-3.654, P = 0.010), cardiac failure (HR 4.620; 95% CI 2.216-9.632; P < 0.001), and pre-RRT SOFA score (HR 1.152; 95% CI 1.065-1.247; P < 0.001) were independent indicators for in-hospital mortality (Table (Table3).3). The predictive power for in-hospital mortality of LD (HR 1.756; 95% CI, 1.003-3.074; P = 0.049) persisted in the additional Cox regression analysis in which the three variables (sepsis before RRT, mechanical ventilation, and diabetes) was forced into the analysis regardless of P value. From the analysis comparing 'sRIFLE' categories against each other, we found a significant RR of 'sRIFLE-F' (RR 3.194, P = 0.014), and a trend of increased risk of 'sRIFLE-I' (RR 2.

121, P = 0.080) as comparing with ‘sRIFLE-R’ (Table (Table44).Table 3Independent predictors for in-hospital mortality using Cox proportional hazards modelTable 4Relative risk (RR) for in-hospital mortality using Cox proportional hazards modelBy Kaplan-Meier curves, we demonstrated that the survival proportion was much lower in LD group as compared with ED group (P = 0.022; Figure Figure22).Figure 2Cumulative patient survival between early and late dialysis groups defined by RIFLE classification. By Kaplan-Meier method. Brown solid line = early dialysis group (RIFLE-0 and -I, n = 51); black dashed line = late dialysis group (RIFLE-R and -F, n = …DiscussionRIFLE classification and RRT initiationThe RIFLE classification [24] was proposed to standardize the severity of AKI, and it’s predictive value for patient outcome was supported by many studies [25,26,32].

The stratification about Dacomitinib the timing of RRT initiation by RIFLE classification has been recommended by the Acute Kidney Injury Network [33]. Our work is among the first few studies examining the relation between prognosis and timing of RRT initiation. We found that late initiation of RRT as defined by ‘sRIFLE-I’ and ‘sRIFLE-F’ is an independent predictor for in-hospital mortality in a relative homogenous group of patients with AKI after major abdominal surgery.