Skip to main content

Severe renal dysfunction measured by pRIFLE in children is an independent factor associated with death and not predicted by PIM2


The objective was to evaluate the effect of the renal dysfunction measured by pRIFLE on clinical outcome in children admitted to the pediatric intensive care unit (PICU).


A retrospective cohort involving all children admitted between August 2009 and July 2010 to a Brazilian PICU located in a university-affiliated hospital. Patients were classified according to the pRIFLE at admission as well the maximum pRIFLE during the PICU stay. The endpoints were: length of stay (LOS) in the PICU, LOS on mechanical ventilation, mortality rate quoted by predicted mortality of the Pediatric Index of Mortality (PIM2).


In total, 375 children were included in the study. A total 169 (45%) of them presented renal dysfunction according to the pRIFLE. Renal injury and renal failure were associated with higher LOS in the PICU and length of mechanical ventilation. The observed and predicted mortality by PIM2 did not show differences. However, the more severe renal presentation (Injury and Failure) was associated with higher mortality rate and was not predicted by PIM2 (8% vs. 11%, P 0.01).


Renal dysfunction measured by pRIFLE is a very common finding (45%) among pediatric patients admitted to the PICU. The more severe renal affection is associated with higher mortality, length of MV and length of PICU stay.


  1. 1.

    Picca S, Picardo S: Acute kidney injury in an infant after cardiopulmonary bypass. Semin Nephrol 2008, 28: 470-476. 10.1016/j.semnephrol.2008.05.006

    Article  PubMed  Google Scholar 

  2. 2.

    Hassinger AB, Becker CL: Predictive power of serum cistatin C. Pediatr Crit Care Med 2012, 13: 435-440. 10.1097/PCC.0b013e318238b43c

    Article  PubMed  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to J Piva.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Piva, J., Lago, P., Pedro, G. et al. Severe renal dysfunction measured by pRIFLE in children is an independent factor associated with death and not predicted by PIM2. Crit Care 17, P409 (2013).

Download citation


  • Mortality Rate
  • Renal Failure
  • Mechanical Ventilation
  • High Mortality
  • Pediatric Patient