Ultrasound Diagnosis Department, Jinan Third People's Hospital, 250132 Jinan, Shandong, China.
Nephrology Department, The Second Hospital of Dalian Medical University, 116027 Dalian, Liaoning, China.
Arch Esp Urol. 2024 Jul;77(6):651-657. doi: 10.56434/j.arch.esp.urol.20247706.89.
Early diagnosis of postoperative acute kidney injury (AKI) is crucial. This study investigated the changes and early diagnostic value of Doppler ultrasound parameters in patients with AKI after laparoscopic radical prostatectomy (LRP).
This study retrospectively analysed the clinical data of 198 patients with LRP undergoing Doppler ultrasound from May 2020 to May 2022. The incidence of AKI after LRP was measured based on diagnostic criteria of AKI developed by Kidney Disease: Improving Global Outcomes. The patients were divided into AKI group (n = 12) and non-AKI group (n = 186) in accordance with the presence or absence of AKI. This study compared changes in Doppler ultrasound parameters between two groups, and evaluated the clinical efficacy of single and combined diagnosis of ultrasound parameters using receiver operating characteristic (ROC) curve and area under the curve (AUC).
Twelve patients experienced postoperative AKI, with an incidence rate of 6.06%. No significant difference was found in baseline data, serum creatinine (Scr), urinary output and blood potassium levels of both groups ( > 0.05). The urinary output 1 day after surgery was significantly lower than that before surgery ( < 0.05). The AKI group demonstrated higher pulsatility index (PI) and resistive index (RI) of the renal interlobar artery than the non-AKI group ( < 0.05), with no significant difference in peak systolic velocity (PSV) in both groups ( > 0.05). No significant difference was observed in the Doppler ultrasound parameters of renal segmental artery and main renal artery ( > 0.05). The AUCs in the PI of the renal interlobar artery, the RI of the renal interlobar artery, and the combined diagnosis were 0.720, 0.704 and 0.724, respectively. ROC curve showed that the above two Doppler ultrasound parameters had good diagnostic efficacy for AKI after LRP ( < 0.05).
The PI and RI of renal interlobar artery in the AKI group after LRP were significantly different from those in the non-AKI group. These two Doppler ultrasound parameters had good diagnostic efficacy in the early identification of AKI after LRP. Thus, they could provide reference and guidance for clinical practice.
术后急性肾损伤（AKI）的早期诊断至关重要。本研究探讨了腹腔镜根治性前列腺切除术（LRP）后 AKI 患者多普勒超声参数的变化及其早期诊断价值。
本研究回顾性分析了 2020 年 5 月至 2022 年 5 月期间 198 例行多普勒超声检查的 LRP 患者的临床资料。根据改善全球肾脏病预后组织（KDIGO）制定的 AKI 诊断标准，测量 LRP 后 AKI 的发生率。根据是否发生 AKI，将患者分为 AKI 组（n=12）和非 AKI 组（n=186）。本研究比较了两组间多普勒超声参数的变化，并采用受试者工作特征（ROC）曲线和曲线下面积（AUC）评估超声参数单一及联合诊断的临床效能。
12 例患者术后发生 AKI，发生率为 6.06%。两组间基线资料、术前血清肌酐（Scr）、尿量、血钾水平比较，差异均无统计学意义（>0.05）。术后 1 天尿量较术前明显减少（<0.05）。AKI 组肾叶间动脉搏动指数（PI）和阻力指数（RI）高于非 AKI 组（<0.05），两组间收缩期峰值流速（PSV）比较，差异无统计学意义（>0.05）。肾段动脉和主肾动脉的多普勒超声参数比较，差异均无统计学意义（>0.05）。肾叶间动脉 PI、肾叶间动脉 RI 和联合诊断的 AUC 分别为 0.720、0.704 和 0.724。ROC 曲线显示，上述两项多普勒超声参数对 LRP 后 AKI 具有良好的诊断效能（<0.05）。
LRP 后 AKI 组肾叶间动脉 PI 和 RI 与非 AKI 组比较差异有统计学意义。这两项多普勒超声参数对 LRP 后 AKI 的早期识别具有良好的诊断效能，可为临床实践提供参考和指导。
