Diagnostic accuracy of arterial and venous renal Doppler assessment for acute kidney injury in critically ill patients: A prospective study

SICS Study Group, Renske Wiersema*, Thomas Kaufmann, Hilde N van der Veen, Robbert J de Haas, Casper F M Franssen, Jacqueline Koeze, Iwan C C van der Horst, Frederik Keus

*Corresponding author for this work

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Abstract

Background and purpose: Renal Resistive Index (RRI) and Venous Impedance Index (VII) might be of additional value for diagnosing Acute Kidney Injury (AKI). The purpose of this study was to assess the diagnostic accuracy of RRI and VII for AKI.

Materials and methods: In the prospective Simple Intensive Care Studies-II (NCT03577405), we measured RRI and VII in acutely admitted adult intensive care patients within 24 h of admission. AKI was defined by the Kidney Disease Improving Global Outcome (KDIGO) criteria. The primary outcome was persistent AKI, defined as nonresolved AKI on day three. We tested specificity, sensitivity and diagnostic accuracy of both RRI and VII for persistent AKI.

Results: In total, 371 patients were included of whom 123 patients (33%) had persistent AKI. RRI and VII did not differ between patients with and those without persistent AKI (p = .08 and p = .59). RRI had a moderate specificity (72%, 95%CI 66-78%) and low sensitivity (32%, 95%Cl 24-41%) and VII had high sensitivity (93%, 95%Cl 85-98%) and low specificity (11%, 95%Cl 6-16%) for persistent AKI. Overall diagnostic accuracy of RRI and VII was moderate.

Conclusions: In acutely admitted critically ill patients, measures of renal perfusion by renal ultrasound were not different between patients with and without AKI, and show limited diagnostic accuracy for AKI. (C) 2020 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)57-62
Number of pages6
JournalJournal of Critical Care
Volume59
Early online date2020
DOIs
Publication statusPublished - Oct-2020

Keywords

  • Prospective study
  • Ultrasound
  • Acute kidney injury
  • Diagnostic imaging
  • Critical care
  • Resistive index
  • Doppler
  • RESISTIVE INDEX
  • ULTRASONOGRAPHY
  • PRESSURE

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