The following is the summary of “Performance of the renal resistive index and usual clinical indicators in predicting persistent AKI” published in the November 2022 issue of Renal failure by Fu, et al.
It would be ideal for maximizing treatment and preventing further decline in kidney function if patients with persistent acute kidney injury (AKI) were identified early on. Preliminary investigations using the Doppler-based renal resistive index (RI) to predict chronic AKI have shown encouraging results. The purpose of this study was to compare the efficacy of renal RI, clinical markers, and their combinations in predicting the short-term prognosis of the kidneys in patients with septic shock. Researchers used prospective research data to conduct a retrospective analysis between November 2017 and October 2018 at a single-center general ICU. People who had already gone into septic shock were considered. Clinical indicators were assessed at the time of inclusion, and renal RI was measured within the first 12 hours after ICU admission following hemodynamic stabilization. In this study, patients with AKI who did not improve within 72 hours were considered to have persistent AKI.
For this study, investigators employed multivariate logistic regression to identify and isolate the most important factors in explaining long-term AKI. Receiver operating characteristic curve analysis was used to assess discriminatory ability. Of the 102 patients, 39 were diagnosed with chronic AKI. Patients with chronic AKI had an increased renal RI compared to those without persistent AKI (0.70 ± 0.05 vs. 0.66 ± 0.05; P=0.001). The area under the receiver operating characteristic curve (AUROC) of 0.699 [95% CI 0.600-0.786] indicates that RI is not a good predictor of persistent AKI.
With an AUROC of 0.877 (95% CI 0.797-0.933, P=0.0012), a clinical prediction model was developed using serum creatinine at inclusion and the nonrenal SOFA score to improve the capacity to predict non-recovery. The predictive efficacy of this model was not enhanced by including renal RI. The doppler-based renal resistive index did not improve clinical prediction in patients with septic shock beyond that provided by a combination of inclusion serum creatinine and the nonrenal SOFA score.
Source: tandfonline.com/doi/full/10.1080/0886022X.2022.2147437