Yazici Mümin Murat, Hamdioğlu Enes, Parça Nurullah, Altuntaş Gürkan, Yavaşi Özcan, Bilir Özlem
Department of Emergency Medicine, Recep Tayyip Erdoğan University Training and Research Hospital, Rize, 53020, Turkey.
BMC Emerg Med. 2025 Jan 9;25(1):7. doi: 10.1186/s12873-025-01172-5.
The incidence of contrast-induced acute kidney injury (CI-AKI) in the general population ranges from 0.6 to 2.3%, whereas for specific high-risk patients, the incidence can reach more than 30-40%. Ultrasound measurements of the development of CI-AKI after contrast-enhanced imaging for diagnosis in the emergency department (ED) have yet to be adequately studied. Accordingly, we aimed to evaluate the usefulness of Doppler ultrasound measurements for predicting CI-AKI in patients with normal renal function.
This prospective, observational, single-center study was conducted in the ED of a tertiary teaching and research hospital between 1 January and 1 July 2024. All patients who presented to the tertiary training and research hospital ED, who were admitted to the hospital with a decision to undergo contrast-enhanced tomography for diagnosis, and who did not meet any exclusion criteria were included in the study. Patients included in the study were evaluated by ultrasonographic measurements (interlobar renal artery peak systolic velocity (PSV), interlobar renal artery end-diastolic velocity (EDV), inferior vena cava (IVC) collapsibility index, and renal resistive index (RRI)).
The postcontrast RRI cutoff values were calculated to predict CI-AKI. The area under the curve (AUC) for the postcontrast RRI was 0.914, and the cutoff value for the postcontrast RRI was 0.70 (≥), exhibiting 72.7% sensitivity and 95.6% specificity.
Postcontrast RRI ultrasound measurements performed after diagnostic contrast imaging in the ED show high specificity in predicting CI-AKI development. Postcontrast ultrasound measurements may predict CI-AKI development, allowing further measures to be taken. Further studies are needed to confirm these findings.
Clinical trial number: not applicable.
普通人群中对比剂诱导的急性肾损伤（CI-AKI）的发生率为0.6%至2.3%，而对于特定的高危患者，发生率可超过30% - 40%。急诊室（ED）中用于诊断的对比增强成像后CI-AKI发生情况的超声测量尚未得到充分研究。因此，我们旨在评估多普勒超声测量对预测肾功能正常患者发生CI-AKI的有效性。
这项前瞻性、观察性、单中心研究于2024年1月1日至7月1日在一家三级教学研究医院的急诊室进行。所有到该三级培训研究医院急诊室就诊、因决定接受对比增强断层扫描进行诊断而入院且未符合任何排除标准的患者均纳入研究。纳入研究的患者通过超声测量（肾叶间动脉收缩期峰值流速（PSV）、肾叶间动脉舒张末期流速（EDV）、下腔静脉（IVC）塌陷指数和肾阻力指数（RRI））进行评估。
计算对比剂注射后的RRI临界值以预测CI-AKI。对比剂注射后RRI的曲线下面积（AUC）为0.914，对比剂注射后RRI的临界值为0.70（≥），敏感性为72.7%，特异性为95.6%。
急诊室诊断性对比成像后进行的对比剂注射后RRI超声测量在预测CI-AKI发生方面具有高特异性。对比剂注射后超声测量可能预测CI-AKI的发生，从而能够采取进一步措施。需要进一步研究来证实这些发现。
临床试验编号：不适用。
