肾血管阻力指数和血清生物标志物对脓毒症相关急性肾损伤的预测价值：一项回顾性研究。

The predictive value of renal vascular resistance index and serum biomarkers for sepsis-associated acute kidney injury: a retrospective study.

作者信息

Huang Daofeng, Yang Zhaobin, Qiu Luzhen, Lin Jinzhan, Cheng Xiaomei

机构信息

Intensive Care Unit of the Internal Medicine Department, Zhangzhou Municipal Hospital Affiliated to Fujian Medical University, No. 59 Shengli West Road, Xiangcheng District, Zhangzhou City, Fujian Province, 363000, China.

出版信息

BMC Nephrol. 2025 Apr 25;26(1):208. doi: 10.1186/s12882-025-04131-1.

DOI:10.1186/s12882-025-04131-1

PMID:40281493

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12023560/

Abstract

BACKGROUND

Sepsis-associated acute kidney injury (AKI) presents a significant clinical challenge, necessitating the identification of predictive indicators for early detection and intervention. This retrospective case-control study aimed to investigate the predictive potential of renal vascular resistance index and serum biomarkers in sepsis-associated AKI.

METHODS

A cohort of 108 patients diagnosed with sepsis was separated into two groups-those with acute kidney injury (AKI) and those without-using the diagnostic criteria established by the kidney disease: Improving Global Outcomes (KDIGO) guidelines. Various demographic, clinical, and laboratory parameters were collected, including renal resistive index, serum biomarkers, disease severity scores, and clinical outcomes. Statistical analyses, including t-tests, correlation analysis, receiver operating characteristic (ROC) analysis, and joint model construction, were conducted to evaluate the predictive value of these parameters.

RESULTS

The AKI group exhibited higher APACHE II and SOFA scores compared to the non-AKI group, indicating the association between disease severity scores and the presence of AKI in septic patients. Renal resistive index and several serum biomarkers, including C-reactive protein and procalcitonin, were notably elevated in the AKI group. Correlation analysis demonstrated significant associations between renal vascular resistance index, serological biomarkers, and clinical severity scores. ROC analysis revealed that several parameters, including Renal Resistive Index (AUC = 0.667), C-reactive Protein (CRP, AUC = 0.665), Platelet Count (AUC = 0.666), and Prothrombin Time (AUC = 0.669), demonstrated moderate diagnostic performance for predicting sepsis-associated AKI. These parameters were subsequently incorporated into a joint predictive model, which exhibited robust diagnostic accuracy with an AUC of 0.780, highlighting its potential utility as a reliable predictive tool in clinical practice.

CONCLUSIONS

The study findings underscore the potential for integrating renal vascular parameters and serum biomarkers in clinical risk stratification and early intervention strategies for sepsis-associated AKI.

CLINICAL REGISTRATION

Not applicable.

摘要

背景

脓毒症相关急性肾损伤（AKI）是一项重大的临床挑战，需要识别预测指标以便早期检测和干预。这项回顾性病例对照研究旨在探讨肾血管阻力指数和血清生物标志物在脓毒症相关AKI中的预测潜力。

方法

根据改善全球肾脏病预后组织（KDIGO）指南制定的诊断标准，将108例诊断为脓毒症的患者分为两组，即急性肾损伤（AKI）组和非AKI组。收集了各种人口统计学、临床和实验室参数，包括肾阻力指数、血清生物标志物、疾病严重程度评分和临床结局。进行了统计分析，包括t检验、相关性分析、受试者工作特征（ROC）分析和联合模型构建，以评估这些参数的预测价值。

结果

与非AKI组相比，AKI组的急性生理与慢性健康状况评分系统II（APACHE II）和序贯器官衰竭评估（SOFA）评分更高，表明疾病严重程度评分与脓毒症患者AKI的存在之间存在关联。AKI组的肾阻力指数和几种血清生物标志物，包括C反应蛋白和降钙素原，显著升高。相关性分析表明肾血管阻力指数、血清生物标志物与临床严重程度评分之间存在显著关联。ROC分析显示，包括肾阻力指数（曲线下面积[AUC]=0.667）、C反应蛋白（CRP，AUC=0.665）、血小板计数（AUC=0.666）和凝血酶原时间（AUC=0.669）在内的几个参数在预测脓毒症相关AKI方面具有中等诊断性能。随后将这些参数纳入联合预测模型，该模型表现出强大的诊断准确性，AUC为0.780，突出了其在临床实践中作为可靠预测工具的潜在效用。