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.