scholarly journals Renal Resistive Index as a Predictor of Acute Kidney Injury and Mortality in COVID-19 Critically Ill Patients

2021 ◽  
pp. 1-8
Author(s):  
Edgar Garcia Cruz ◽  
Blanca Estela Broca Garcia ◽  
Daniel Manzur Sandoval ◽  
Rodrigo Gopar-Nieto ◽  
Francisco Javier Gonzalez Ruiz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cox Model ◽  
Resistive Index ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Renal Resistive Index ◽  
Bedside Method

<b><i>Background:</i></b> Acute kidney injury (AKI) in patients with COVID-19 can be caused by multiple mechanisms. Renal resistive index (RRI) is a noninvasive instrument to evaluate kidney hemodynamics, and it is obtained by analysis of intrarenal arterial waves using Doppler ultrasound. This study aimed to determine the role of RRI in predicting AKI and adverse outcomes in critically ill patients with COVID-19. <b><i>Methods:</i></b> This cross-sectional study included 65 patients with confirmed SARS-CoV-2 pneumonia admitted to the critical care unit from April 1, 2020, to June 20, 2020. Informed consent was obtained from all individual participants included in the study. Cardiac, pulmonary, and kidney ultrasonographic evaluations were performed in a protocolized way. <b><i>Results:</i></b> In this cohort, 65 patients were included, mean age was 53.4 years, 79% were male, and 35% were diabetic. Thirty-four percent of patients developed AKI, 12% required RRT, and 35% died. Of the patients who developed AKI, 68% had RRI ≥ 0.7. Also, 75% of the patients who required RRT had RRI ≥ 0.7. In the adjusted Cox model, the RRI ≥ 0.7 was associated with higher mortality (HR 2.86, 95% CI: 1.19–6.82, <i>p</i> = 0.01). <b><i>Conclusions:</i></b> Critical care ultrasonography is a noninvasive, reproducible, and accurate bedside method that has proven its usefulness. An elevated RRI may have a role in predicting AKI, RRT initiation, and mortality in patients with severe SARS-CoV-2 pneumonia.

scholarly journals Comparison of Neutrophil Gelatinase-associated Lipocalin and Renal Resistive Index as Acute Kidney Injury Predictor in Critically Ill Patients at ICU H. Adam Malik Hospital Medan

2021 ◽  
Vol 9 (B) ◽  
pp. 1637-1639
Author(s):  
Muhammad Aldi Rivai Ginting ◽  
Achsanuddin Hanafie ◽  
Bastian Lubis
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index ◽  
Ngal Level ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

BACKGROUND: Acute kidney injury (AKI) is a complication found in critically ill patients. Current consensus explains that diagnosis of AKI based on increased serum creatinine and decreased urine output. Neutrophil gelatinase-associated lipocalin (NGAL) level is increased a few hours after tubular damage occurred and can predict AKI more significantly than serum creatinine. Renal resistive index (RRI) is also a good marker in predicting the early stage of AKI. AIM: This study aimed to compare RRI and NGAL level as marker to predict incidence of AKI in critically ill patients treated in the Intensive Care Unit (ICU) at H. Adam Malik Hospital Medan. METHODS: This was an observational prospective cohort study and conducted in ICU at H. Adam Malik Hospital Medan in April-May 2021. This study had been approved by the Ethics Committee of Faculty of Medicine, Sumatera Utara University and H. Adam Malik Hospital Medan. Inclusion criteria are critical patients aged 18–65 years with 1st and 2nd priority level. Consecutive sampling was used. Resistive Index (RI) measured using USG Doppler by researcher and the results confirmed by ICU supervisors, while urine NGAL level measured within 3 h after ICU admission. Plasma urea and creatinine level measured after 24h after ICU admission. RESULTS: A total of 40 samples were collected; percentage of men and women are 66–35%, respectively (p = 0.001). There was a significant difference RI between AKI-group and non-AKI group (0.719 ± 0.060 and 0.060 ± 0.077, respectively) (p = 0.001). RI has a sensitivity of 71%, specificity of 84%, and accuracy of 87% in predicting occurrence of AKI with AUROC = 0.873. Meanwhile, NGAL has a sensitivity, specificity, and accuracy (66%, 89%, 78%, respectively) in early prediction of AKI incidence in critically ill patients. CONCLUSION: RI value was higher in AKI group than non-AKI group. RRI has better sensitivity than NGAL in predicting incidence of AKI.

Diagnostic accuracy of Doppler renal resistive index for reversibility of acute kidney injury in critically ill patients

2010 ◽  
Vol 37 (1) ◽  
pp. 68-76 ◽  
Author(s):  
Michael Darmon ◽  
Frédérique Schortgen ◽  
Frederic Vargas ◽  
Aissam Liazydi ◽  
Benoît Schlemmer ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Diagnostic Accuracy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index

Plasma cystatin C versus renal resistive index as early predictors of acute kidney injury in critically ill neonates

2020 ◽  
Vol 16 (2) ◽  
pp. 206.e1-206.e8
Author(s):  
Akram E. El-sadek ◽  
Mohamed A. El-Gamasy ◽  
Eman G. Behiry ◽  
Ahmed A. Torky ◽  
Mohamed A. Fathy
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Cystatin C ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index ◽  
Early Predictors ◽  
Critically Ill Neonates

scholarly journals Prediction models for acute kidney injury in critically ill patients: a protocol for systematic review and critical appraisal

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e046274
Author(s):  
Danqiong Wang ◽  
Weiwen Zhang ◽  
Jian Luo ◽  
Honglong Fang ◽  
Shanshan Jing ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Kidney Injury ◽  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Appraisal ◽  
Prediction Models ◽  
External Validation ◽  
Kidney Injury ◽  
Risk Of Bias

IntroductionAcute kidney injury (AKI) has high morbidity and mortality in intensive care units, which can lead to chronic kidney disease, more costs and longer hospital stay. Early identification of AKI is crucial for clinical intervention. Although various risk prediction models have been developed to identify AKI, the overall predictive performance varies widely across studies. Owing to the different disease scenarios and the small number of externally validated cohorts in different prediction models, the stability and applicability of these models for AKI in critically ill patients are controversial. Moreover, there are no current risk-classification tools that are standardised for prediction of AKI in critically ill patients. The purpose of this systematic review is to map and assess prediction models for AKI in critically ill patients based on a comprehensive literature review.Methods and analysisA systematic review with meta-analysis is designed and will be conducted according to the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS). Three databases including PubMed, Cochrane Library and EMBASE from inception through October 2020 will be searched to identify all studies describing development and/or external validation of original multivariable models for predicting AKI in critically ill patients. Random-effects meta-analyses for external validation studies will be performed to estimate the performance of each model. The restricted maximum likelihood estimation and the Hartung-Knapp-Sidik-Jonkman method under a random-effects model will be applied to estimate the summary C statistic and 95% CI. 95% prediction interval integrating the heterogeneity will also be calculated to pool C-statistics to predict a possible range of C-statistics of future validation studies. Two investigators will extract data independently using the CHARMS checklist. Study quality or risk of bias will be assessed using the Prediction Model Risk of Bias Assessment Tool.Ethics and disseminationEthical approval and patient informed consent are not required because all information will be abstracted from published literatures. We plan to share our results with clinicians and publish them in a general or critical care medicine peer-reviewed journal. We also plan to present our results at critical care international conferences.OSF registration number10.17605/OSF.IO/X25AT.

scholarly journals Renal resistive index as an early predictor and discriminator of acute kidney injury in critically ill patients; A prospective observational cohort study

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0197967 ◽  
Author(s):  
Jelle L. G. Haitsma Mulier ◽  
Sander Rozemeijer ◽  
Jantine G. Röttgering ◽  
Angelique M. E. Spoelstra-de Man ◽  
Paul W. G. Elbers ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cohort Study ◽  
Critically Ill Patients ◽  
Resistive Index ◽  
Kidney Injury ◽  
Observational Cohort Study ◽  
Renal Resistive Index ◽  
Prospective Observational Cohort Study ◽  
Observational Cohort ◽  
Early Predictor

scholarly journals Renal Resistive Index is Associated With Acute Kidney Injury in COVID-19 Patients Treated in the ICU

2020 ◽  
Author(s):  
Mårten Renberg ◽  
Olof Jonmarker ◽  
Naima Kilhamn ◽  
Claire Rimes-Stigare ◽  
Max Bell ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Resistive Index ◽  
Kidney Injury ◽  
Observational Cohort Study ◽  
University Hospital ◽  
Renal Resistive Index ◽  
Promising Tool ◽  
Observational Cohort ◽  
Stage 1

Abstract Background: Renal resistive index (RRI) is a promising tool for prediction of acute kidney injury (AKI) in critically ill patients but is not described among patients with Coronavirus disease 2019 (COVID-19). The aim of this study was to describe the pattern of RRI in relation to AKI in patients with COVID-19 treated in the intensive care unit.Methods: In this observational cohort study, RRI was measured in COVID-19 patients in six ICUs at two sites of a Swedish University Hospital. AKI was defined by the creatinine criteria in the Kidney Disease Improving Global Outcome classification. We investigated the association between RRI and AKI diagnosis, different AKI stages and urine output.Results: RRI was measured in 51 patients, of which 23 patients (45%) had AKI at the time of measurement. Median RRI in patients with AKI was 0.80 (IQR 0.71-0.85) compared to 0.72 (IQR 0.67-0.78) in patients without AKI (p=0.004). Compared to patients without AKI, RRI was higher in patients with AKI stage 3 (median 0.83, IQR 0.71-0.85, p=0.006) but not in patients with AKI stage 1 (median 0.76, IQR 0.71-0.83, p=0.347) or AKI stage 2 (median 0.79, min/max 0.79/0.80, n=2, p=0.134). RRI was higher in patients with an ongoing AKI episode compared to patients who never developed AKI (median 0.72, IQR 0.69-0.78, p=0.015) or patients who developed AKI but had recovered at the time of measurement (median 0.68, IQR 0.67-0.81, p=0.021). Oliguric patients had higher RRI (median 0.84, IQR 0.83-0.85) compared to non-oliguric patients (median 0.74, IQR 0.69-0.81) (p=0.009).Conclusions: Critically ill COVID-19 patients with AKI have higher RRI compared to those without AKI, and elevated RRI may have a role in identifying severe and oliguric AKI in these patients.

scholarly journals Renal resistive index is associated with acute kidney injury in COVID-19 patients treated in the intensive care unit

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mårten Renberg ◽  
Olof Jonmarker ◽  
Naima Kilhamn ◽  
Claire Rimes-Stigare ◽  
Max Bell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Resistive Index ◽  
Kidney Injury ◽  
University Hospital ◽  
Renal Resistive Index ◽  
Promising Tool ◽  
Stage 1

Abstract Background Renal resistive index (RRI) is a promising tool for the assessment of acute kidney injury (AKI) in critically ill patients in general, but its role and association to AKI among patients with Coronavirus disease 2019 (COVID-19) is not known. Objective The aim of this study was to describe the pattern of RRI in relation to AKI in patients with COVID-19 treated in the intensive care unit. Methods In this observational cohort study, RRI was measured in COVID-19 patients in six intensive care units at two sites of a Swedish University Hospital. AKI was defined by the creatinine criteria in the Kidney Disease Improving Global Outcomes classification. We investigated the association between RRI and AKI diagnosis, different AKI stages and urine output. Results RRI was measured in 51 patients, of which 23 patients (45%) had AKI at the time of measurement. Median RRI in patients with AKI was 0.80 (IQR 0.71–0.85) compared to 0.72 (IQR 0.67–0.78) in patients without AKI (p = 0.004). Compared to patients without AKI, RRI was higher in patients with AKI stage 3 (median 0.83, IQR 0.71–0.85, p = 0.006) but not in patients with AKI stage 1 (median 0.76, IQR 0.71–0.83, p = 0.347) or AKI stage 2 (median 0.79, min/max 0.79/0.80, n = 2, p = 0.134). RRI was higher in patients with an ongoing AKI episode compared to patients who never developed AKI (median 0.72, IQR 0.69–0.78, p = 0.015) or patients who developed AKI but had recovered at the time of measurement (median 0.68, IQR 0.67–0.81, p = 0.021). Oliguric patients had higher RRI (median 0.84, IQR 0.83–0.85) compared to non-oliguric patients (median 0.74, IQR 0.69–0.81) (p = 0.009). After multivariable adjustment, RRI was independently associated with AKI (OR for 0.01 increments of RRI 1.22, 95% CI 1.07–1.41). Conclusions Critically ill COVID-19 patients with AKI have higher RRI compared to those without AKI, and elevated RRI may have a role in identifying severe and oliguric AKI at the bedside in these patients.

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