Variations of renal Doppler indices during the initial 24-hour predict acute kidney injury in patients with sepsis: A single-center observational case-control clinical study

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL Clinics Pub Date : 2025-01-01 DOI:10.1016/j.clinsp.2024.100538

Xing Chen, Wen Wu, Chao Lei, Chong Li, Zhaohui Zhang, Xingguang Qu

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Abstract

Background and objective

The aim of this retrospective observational case-control study was to examine the significance of different renal Doppler marker variations within the initial 24-hour period as potential predictors of Acute Kidney Injury (AKI) in patients with sepsis.

Methods

A total of 198 sepsis patients were enrolled and categorized into two groups: the AKI group (n = 136) and the non-AKI group (n = 62). Three renal Doppler indices, Renal Resistive Index (RRI), Power Doppler Ultrasound (PDU) score and Renal Venous Stasis Index (RVSI), were measured within 6h (T0) and at 24h (T1) after ICU admission.

Results

The AKI group had more hypertension patients than the non-AKI group (p = 0.047). The cases of the AKI group showed higher levels of CRP (p = 0.001), PCT (p < 0.001), lactate (p < 0.001), AST (p = 0.003), ALT (p = 0.049), total bilirubin (p = 0.034), BNP (p = 0.019) and cTnI (p = 0.012). The RRI at T1 was significantly higher in the AKI group (p = 0.037). AKI group exhibited a lower incidence of reduced RRI at T1 compared with non-AKI group (p < 0.001). After controlling for age, sex, and BMI through partial correlation analysis, the results indicated significant associations between SA-AKI and CVP (r = -0.473), SOFA score (r = 0.425), lactate (r = 0.378), and RRI reduction (r = -0.344) in sepsis patients. The multivariate logistic regression analysis showed that variables including CVP, SOFA score, CRP, lactate, VIS, and RRI not reduced following 24h of ICU treatment were predictive indicators for early detection of SA-AKI in sepsis patients.

Conclusion

CVP, SOFA score, CRP, lactate, VIS, and RRI not reduction following 24h of ICU treatment can be utilized as predictive indicators for early detection of SA-AKI in sepsis patients.

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肾脏多普勒指数在最初24小时内的变化预测脓毒症患者的急性肾损伤：一项单中心观察性病例对照临床研究。

背景和目的：本回顾性观察性病例对照研究的目的是探讨24小时内不同肾脏多普勒标志物变化作为脓毒症患者急性肾损伤（AKI）的潜在预测因素的意义。方法：将198例脓毒症患者分为AKI组（n = 136）和非AKI组（n = 62）。分别于ICU入院后6h （T0）和24h （T1）测量肾阻力指数（RRI）、功率多普勒超声（PDU）评分和肾静脉淤积指数（RVSI）三项肾多普勒指标。结果：AKI组高血压患者多于非AKI组（p = 0.047）。AKI组患者CRP （p = 0.001）、PCT （p < 0.001）、乳酸（p < 0.001）、AST （p = 0.003）、ALT （p = 0.049）、总胆红素（p = 0.034）、BNP （p = 0.019）、cTnI （p = 0.012）水平升高。AKI组T1时的RRI显著高于对照组（p = 0.037）。与非AKI组相比，AKI组T1时RRI降低的发生率较低（p < 0.001）。通过偏相关分析控制年龄、性别和BMI后，结果显示脓毒症患者SA-AKI与CVP （r = -0.473）、SOFA评分（r = 0.425）、乳酸（r = 0.378）、RRI降低（r = -0.344）存在显著相关。多因素logistic回归分析显示，CVP、SOFA评分、CRP、乳酸、VIS、RRI等变量在ICU治疗24h后未降低是脓毒症患者SA-AKI早期发现的预测指标。结论：ICU治疗24h后CVP、SOFA评分、CRP、乳酸、VIS、RRI均未降低，可作为脓毒症患者SA-AKI早期检测的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.