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05.10.2018 | Original

Performance of Doppler-based resistive index and semi-quantitative renal perfusion in predicting persistent AKI: results of a prospective multicenter study

verfasst von: Michael Darmon, Aurelie Bourmaud, Marie Reynaud, Stéphane Rouleau, Ferhat Meziani, Alexandra Boivin, Mourad Benyamina, François Vincent, Alexandre Lautrette, Christophe Leroy, Yves Cohen, Matthieu Legrand, Jérôme Morel, Jeremy Terreaux, David Schnell

Erschienen in: Intensive Care Medicine | Ausgabe 11/2018

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Abstract

Purpose

The Doppler-based resistive index (RI) and semi-quantitative evaluation of renal perfusion using color Doppler (SQP) have shown promising results for predicting persistent acute kidney injury (AKI) in preliminary studies. This study aimed at evaluating the performance of RI and SQP to predict short-term renal prognosis in critically ill patients.

Methods

Prospective multicenter cohort study including unselected critically ill patients. Renal Doppler was performed at admission to the intensive care unit. The diagnostic performance of RI and SQP to predict persistent AKI at day 3 was evaluated.

Results

Overall, 371 patients were included, of whom 351 could be assessed for short-term renal recovery. Two thirds of the included patients had AKI (n = 233; 66.3%), of whom 136 had persistent AKI (58.4%). Doppler-based RI was higher and SQP lower in AKI patients and according to AKI recovery. Overall performance in predicting persistent AKI was however poor with area under ROC curve of respectively 0.58 (95% CI 0.52–0.64) and 0.59 (95% CI 0.54–0.65) for RI and SQP. Optimal cutoff was respectively 0.71 and 2 for RI and SQP. At optimal cutoff, sensitivity and specificity were 50% (95% CI 41–58%) and 68% (62–74%) for RI and 39% (32–45%) and 75% (66–82%) for SQP.

Conclusion

Although statistically associated with AKI occurrence, RI and SQP perform poorly in predicting persistent AKI at day 3. Further studies are needed to adequately describe factors influencing Doppler-based assessment of renal perfusion and to delineate whether these indicators may be useful at the bedside.

Clinicaltrial.gov

NCT02355314.

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Titel: Performance of Doppler-based resistive index and semi-quantitative renal perfusion in predicting persistent AKI: results of a prospective multicenter study
verfasst von: Michael Darmon
Aurelie Bourmaud
Marie Reynaud
Stéphane Rouleau
Ferhat Meziani
Alexandra Boivin
Mourad Benyamina
François Vincent
Alexandre Lautrette
Christophe Leroy
Yves Cohen
Matthieu Legrand
Jérôme Morel
Jeremy Terreaux
David Schnell
Publikationsdatum: 05.10.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 11/2018
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-018-5386-3

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Performance of Doppler-based resistive index and semi-quantitative renal perfusion in predicting persistent AKI: results of a prospective multicenter study