Predictive Value of Doppler Renal Resistive Index for Prediction of Acute Kidney Injury in Septic Patients in Intensive Care Unit

Abstract

Abstract Background Acute kidney injury (AKI) occurs as a serious complication in septic patients. In its severe form, AKI requires renal replacement therapy, which is applied in 5–13% of intensive care units (ICU) patients. AKI is common in patients confined in ICU and remains to be associated with poor outcomes. According to the current diagnostic criteria, serum creatinine (SCr) and urine volume are used as diagnostic and staging criteria for AKI. Aim of the Work To evaluate predictive value of renal resistive index in detection of acute kidney injury. Measuring flow resistance in the renal circulation, Renal Resistive Index (RRI) could become part of vital organ function assessment using Doppler ultrasound. Patients and Methods This was a prospective descriptive study conducted on 150 ICU patients with sepsis; to evaluate prediction value of renal resistive index in detection of acute kidney injury. Measuring flow resistance in the renal circulation, RRI could become part of vital organ function assessment using Doppler ultrasound. Results We found that; the mean age of all patients was (38.4 ± 13.5) years. Regarding gender of the patients, the majority (62.7%) of patients were males; while (37.3%) were females. Regarding basic clinical data; the average MAP was (57.6 ± 14.8) mmHg, the average APACHE score was (14.6 ± 3.7), and the average SOFA score was (4.2 ± 0.92). Regarding comorbidities; (24.7%) of patients had septic shock, (20%) had DM, (34%) had HTN, and (14.7%) had IHD. Conclusion High RRI on ICU admission was a significant predictor for development of AKI stage 2 ± 3 during the first week. High RRI can be used as an early warning signal RRI, because of its high specificity. A combined score including RRI, APACHE III and fluid balance improved AKI prediction, suggesting that vasoconstriction or poor vascular compliance, severity of disease and positive fluid balance independently contribute to AKI development.