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Acute kidney injury (AKI) is common in critically ill patients and it is directly related to the patient's prognosis and survival. Despite remaining uncertainties regarding the prevalence of AKI in intensive care unit (ICU), the overall incidence of AKI is relatively high, and prompt recognition is necessary to ensure the risk assessment, early diagnosis, clinical outcome, and treatment of critically ill patients. Doppler-based renal resistive index (RRI) mainly reflects vascular bed resistance state, which can be indirect to the extent of the damage of renal parenchyma. It is a relatively objective and quantitative evaluation, and is widely used in clinical prognosis of acute or chronic renal damage evaluation and judgment. This paper reviews the definition of RRI, the measurement methods of RRI, the application and progress of RRI in the field of AKI, the advantages and disadvantages of ultrasonic measurement of RRI, the long-term application of RRI, the effectiveness of RRI in predicting AKI, and the progress in clinical application.
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Objective To explore the value of renal resistance index (RI) and urine oxygen pressure for early prediction of acute kidney injury (AKI) in patients with septic shock.Methods Patients with septic shock were enrolled from August 2018 to November 2018 in intensive care unit (ICU) at Peking Union Medical College Hospital.Subjects' general information and AKI characteristics were assessed.Area under the receiver operating characteristic (ROC) curve was used to analyze the predictive value of RI,urine oxygen pressure,or combination of RI on the occurrence of AKI.Results A total of 72 septic shock patients were enrolled including 29 patients with AKI and 43 without.Logistic regression analysis of AKI risk factors found that RI (OR=1.139,95％CI 1.029-1.261,P=0.012) and urine oxygen pressure (OR=0.957,95％CI 0.923-0.991,P=0.014) at admission were independent risk factors for AKI in patients with septic shock.The sensitivity and specificity of dual RI and urine oxygen pressure in predicting AKI were 65.5％and 76.7％ respectively (AUCROC 0.772,Youden index 0.423).We selected the cut-off value of RI as 0.70,and urine oxygen pressure as 48 mmHg (1 mmHg=0.133 kPa).According to this two cut-off values patients were divided into four groups,those with RI≥0.70 and urine oxygen pressure≤48 mmHg showed the highest incidence of AKI (75％).There was no statistically difference in 28-day survival rate between the four groups (P=0.197).Conclusion High RI and low urine oxygen pressure are independent risk factors for the development of AKI in patients with septic shock.The predictive cut-off values are 0.70 for RI and 48 mmHg for urine oxygen pressure.Combination of RI and urine oxygen pressure has a practical predictive value for AKI in patients with septic shock.
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PURPOSE: The purpose of this study is to assess the usefulness of Doppler parameters in transplanted kidney function. MATERIALS AND METHODS: Doppler parameters, including resistive index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end diastolic velocity (EDV) were measured in the interlobar artery of 55 transplant recipients. Patients were grouped according to glomerular filtration rate (GFR): Group A (GFR or = 30 ml / min / 1.73 m2, n = 28). Doppler parameters were compared between groups and correlated with the GFR. RESULTS: GFR (40.1 +/- 26.9) showed a significant negative correlation with RI (0.69 +/- .08) (p = .002, r = -.414). RI (0.72 vs. 0.67), PI (1.42 vs. 1.23), and EDV (10.5 vs. 15.3) differed significantly between groups (p < .05), however, PSV was not (36.9 vs. 47.1). Patients in group A (n = 11) with a lower RI than the mean had significantly lower PSV (31.7 vs. 45.1; p = .027) and EDV (11.1 vs. 16.7; p = .017), compared with such patients in group B (n = 21). CONCLUSIONS: Doppler parameters are useful for evaluation of function of transplanted kidney. Even if the RI is normal, PSV and EDV may be used as hemodynamic indicators.