Value of the combination of renal resistance index and central venous pressure in the early prediction of sepsis-induced acute kidney injury

Abstract

Purpose: Early prediction of acute kidney injury (AKI) in septic patients is difficult. This study aimed to assess the values of renal resistive index (RI), central venous pressure (CVP), and their combination in the early prediction of sepsis-induced AKI.

Methods: A prospective cohort study was performed in septic patients. The variables potentially associated with AKI were recorded at admission and compared between the AKI and non-AKI groups. The variables independently associated with sepsis-induced AKI were identified using multivariable logistic regression, and the area under the receiver operating characteristic curve (AUROC) analysis was calculated.

Results: A total of 124 septic patients were included. Septic shock (OR, 3.28; P=0.002), high CVP (OR, 1.92; P=0.012) and renal RI (OR, 2.58; P=0.009), low diastolic perfusion pressure (DPP) (OR, 2.15; P=0.010) at admission were independent risk factors for sepsis-induced AKI. The AUROC value of the combination of RI and CVP was greater compared with either RI or CVP alone in predicting sepsis-induced AKI (AUROC=0.858, 0.811, and 0.780, respectively).

Conclusions: The combination of RI and CVP was more valuable than either of the two parameters in the early prediction for sepsis-induced AKI.

Keywords: Acute kidney injury; Central venous pressure; Resistive index; Sepsis; Ultrasonography.