Correlation Between the Inferior Vena Cava/Aorta (Ivc/Ao) Ratio and Serum Lactate Levels in Children With Renal Disorder.

IF 2.5 Q2 UROLOGY & NEPHROLOGY International Journal of Nephrology and Renovascular Disease Pub Date : 2025-01-22 eCollection Date: 2025-01-01 DOI:10.2147/IJNRD.S488639
Dzulfikar Djalil Lukmanul Hakim, Ahmedz Widiasta, Dedi Rachmadi, Sri Endah Rahayunigsih, Putria Rayani Apandi, Riyadi Adrizain, Muhamad Rinaldhi Akbar Martiano
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Abstract

Background: Acute kidney injury (AKI) is common in critically ill children in the PICU, with incidence rates from 2.5% to 58%, impacting mortality and hospital duration. Early AKI detection is vital, but conventional hemodynamic monitoring often lacks specificity. This study investigates the relationship between the inferior vena cava/aortic (IVC/Ao) ratio and serum lactate levels as non-invasive indicators of renal hemodynamics and tissue perfusion in children. Understanding these parameters could improve early diagnosis, aid clinical decisions, and enhance outcomes for pediatric AKI patients, offering an accessible monitoring method for clinicians.

Methods: This cross-sectional study involved 48 pediatric patients aged 5-18 years showing Pediatric Early Warning Score (PEWS) ≥3 and diagnosed with renal disorders. Patients were admitted to the emergency department, high care unit, PICU, and pediatric ward at Dr. Hasan Sadikin Hospital, Bandung, between May and August 2023. AKI was diagnosed using pRIFLE or KDIGO criteria. The IVC/Ao ratio was assessed via transabdominal USG, and serum lactate levels were measured. Spearman correlation analysis was conducted to assess their relationship.

Results: The median (IQR) IVC/Ao ratio was 0.91 (0.70-1.10), and serum lactate levels were 1.5 (1.1-2.4) mmol/L. Spearman correlation analysis revealed a negative correlation between the IVC/Ao ratio and serum lactate (rho = -0.65, p < 0.001).

Conclusion: A decrease in the IVC/Ao ratio correlates with an increase in serum lactate levels in children with AKI.

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肾病患儿下腔静脉/主动脉(Ivc/Ao)比值与血清乳酸水平的相关性
背景:急性肾损伤(AKI)在重症儿童PICU中很常见,发生率为2.5% ~ 58%,影响死亡率和住院时间。早期AKI检测是至关重要的,但传统的血流动力学监测往往缺乏特异性。本研究探讨下腔静脉/主动脉(IVC/Ao)比值与血清乳酸水平作为儿童肾脏血流动力学和组织灌注的无创指标的关系。了解这些参数可以改善早期诊断,帮助临床决策,提高儿科AKI患者的预后,为临床医生提供一种方便的监测方法。方法:本横断面研究纳入48例5-18岁儿科早期预警评分(PEWS)≥3且诊断为肾脏疾病的儿童患者。患者于2023年5月至8月期间入住万隆哈桑·萨迪金医生医院的急诊科、高级监护病房、重症监护病房和儿科病房。AKI的诊断采用prile或KDIGO标准。经腹超声心动图评估IVC/Ao比值,测定血清乳酸水平。采用Spearman相关分析评价两者的关系。结果:中位IVC/Ao比值(IQR)为0.91(0.70 ~ 1.10),血清乳酸水平为1.5 (1.1 ~ 2.4)mmol/L。Spearman相关分析显示IVC/Ao比值与血清乳酸呈负相关(rho = -0.65, p < 0.001)。结论:AKI患儿IVC/Ao比值降低与血清乳酸水平升高相关。
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来源期刊
CiteScore
3.90
自引率
5.00%
发文量
40
审稿时长
16 weeks
期刊介绍: International Journal of Nephrology and Renovascular Disease is an international, peer-reviewed, open-access journal focusing on the pathophysiology of the kidney and vascular supply. Epidemiology, screening, diagnosis, and treatment interventions are covered as well as basic science, biochemical and immunological studies. In particular, emphasis will be given to: -Chronic kidney disease- Complications of renovascular disease- Imaging techniques- Renal hypertension- Renal cancer- Treatment including pharmacological and transplantation- Dialysis and treatment of complications of dialysis and renal disease- Quality of Life- Patient satisfaction and preference- Health economic evaluations. The journal welcomes submitted papers covering original research, basic science, clinical studies, reviews & evaluations, guidelines, expert opinion and commentary, case reports and extended reports. The main focus of the journal will be to publish research and clinical results in humans but preclinical, animal and in vitro studies will be published where they shed light on disease processes and potential new therapies and interventions.
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