Department of Critical Care Medicine, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, China.
Department of Critical Care Medicine, Zhongshan Hospital Fudan University, 180 Fenglin Road, Shanghai, China.
J Crit Care. 2018 Jun;45:204-208. doi: 10.1016/j.jcrc.2018.03.016. Epub 2018 Mar 16.
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.
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.
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).
The combination of RI and CVP was more valuable than either of the two parameters in the early prediction for sepsis-induced AKI.
脓毒症患者急性肾损伤（AKI）的早期预测较为困难。本研究旨在评估肾阻力指数（RI）、中心静脉压（CVP）及其联合在预测脓毒症相关 AKI 中的价值。
对脓毒症患者进行前瞻性队列研究。记录入院时与 AKI 相关的潜在变量，并比较 AKI 组和非 AKI 组之间的差异。采用多变量逻辑回归分析确定与脓毒症相关 AKI 相关的独立变量，并计算受试者工作特征曲线（ROC）下面积（AUROC）。
共纳入 124 例脓毒症患者。脓毒性休克（OR，3.28；P=0.002）、高 CVP（OR，1.92；P=0.012）和高肾 RI（OR，2.58；P=0.009）、低舒张期灌注压（DPP）（OR，2.15；P=0.010）是预测脓毒症相关 AKI 的独立危险因素。RI 和 CVP 联合预测脓毒症相关 AKI 的 AUROC 值大于 RI 或 CVP 单独预测（AUROC=0.858、0.811 和 0.780）。
与两个参数中的任何一个相比，RI 和 CVP 的联合使用在预测脓毒症相关 AKI 方面更有价值。
