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Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study

Non-invasive early prediction of septic acute kidney injury (S-AKI) is still urgent and challenging. Increased Doppler-based renal resistive index (RRI) has been shown to be associated with S-AKI, but its clinical use is limited, which may be explained by the complex effects of systemic circulation....

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Autores principales: Zhang, Ying, Zhu, Jianing, Zhang, Chuyue, Xiao, Jing, Liu, Chao, Wang, Shuo, Zhao, Ping, Zhu, Yaqiong, Wang, Li, Li, Qiuyang, Luo, Yukun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671634/
https://www.ncbi.nlm.nih.gov/pubmed/34926487
http://dx.doi.org/10.3389/fmed.2021.723837
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author Zhang, Ying
Zhu, Jianing
Zhang, Chuyue
Xiao, Jing
Liu, Chao
Wang, Shuo
Zhao, Ping
Zhu, Yaqiong
Wang, Li
Li, Qiuyang
Luo, Yukun
author_facet Zhang, Ying
Zhu, Jianing
Zhang, Chuyue
Xiao, Jing
Liu, Chao
Wang, Shuo
Zhao, Ping
Zhu, Yaqiong
Wang, Li
Li, Qiuyang
Luo, Yukun
author_sort Zhang, Ying
collection PubMed
description Non-invasive early prediction of septic acute kidney injury (S-AKI) is still urgent and challenging. Increased Doppler-based renal resistive index (RRI) has been shown to be associated with S-AKI, but its clinical use is limited, which may be explained by the complex effects of systemic circulation. Echocardiogram allows non-invasive assessment of systemic circulation, which may provide an effective supplement to RRI. To find the value of RRI combined with echocardiographic parameters in the non-invasive early prediction of S-AKI, we designed this experiment with repeated measurements of ultrasonographic parameters in the early stage of sepsis (3, 6, 12, and 24 h) in cecum ligation and puncture (CLP) rats (divided into AKI and non-AKI groups at 24 h based on serum creatinine), with sham-operated group serving as controls. Our results found that RRI alone could not effectively predict S-AKI, but when combined with echocardiographic parameters (heart rate, left ventricular end-diastolic internal diameter, and left ventricular end-systolic internal diameter), the predictive value was significantly improved, especially in the early stage of sepsis (3 h, AUC: 0.948, 95% CI 0.839–0.992, P < 0.001), and far earlier than the conventional renal function indicators (serum creatinine and blood urea nitrogen), which only significantly elevated at 24 h. Our method showed novel advances and potential in the early detection of S-AKI.
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spelling pubmed-86716342021-12-16 Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study Zhang, Ying Zhu, Jianing Zhang, Chuyue Xiao, Jing Liu, Chao Wang, Shuo Zhao, Ping Zhu, Yaqiong Wang, Li Li, Qiuyang Luo, Yukun Front Med (Lausanne) Medicine Non-invasive early prediction of septic acute kidney injury (S-AKI) is still urgent and challenging. Increased Doppler-based renal resistive index (RRI) has been shown to be associated with S-AKI, but its clinical use is limited, which may be explained by the complex effects of systemic circulation. Echocardiogram allows non-invasive assessment of systemic circulation, which may provide an effective supplement to RRI. To find the value of RRI combined with echocardiographic parameters in the non-invasive early prediction of S-AKI, we designed this experiment with repeated measurements of ultrasonographic parameters in the early stage of sepsis (3, 6, 12, and 24 h) in cecum ligation and puncture (CLP) rats (divided into AKI and non-AKI groups at 24 h based on serum creatinine), with sham-operated group serving as controls. Our results found that RRI alone could not effectively predict S-AKI, but when combined with echocardiographic parameters (heart rate, left ventricular end-diastolic internal diameter, and left ventricular end-systolic internal diameter), the predictive value was significantly improved, especially in the early stage of sepsis (3 h, AUC: 0.948, 95% CI 0.839–0.992, P < 0.001), and far earlier than the conventional renal function indicators (serum creatinine and blood urea nitrogen), which only significantly elevated at 24 h. Our method showed novel advances and potential in the early detection of S-AKI. Frontiers Media S.A. 2021-12-01 /pmc/articles/PMC8671634/ /pubmed/34926487 http://dx.doi.org/10.3389/fmed.2021.723837 Text en Copyright © 2021 Zhang, Zhu, Zhang, Xiao, Liu, Wang, Zhao, Zhu, Wang, Li and Luo. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Zhang, Ying
Zhu, Jianing
Zhang, Chuyue
Xiao, Jing
Liu, Chao
Wang, Shuo
Zhao, Ping
Zhu, Yaqiong
Wang, Li
Li, Qiuyang
Luo, Yukun
Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study
title Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study
title_full Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study
title_fullStr Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study
title_full_unstemmed Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study
title_short Non-invasive Early Prediction of Septic Acute Kidney Injury by Doppler-Based Renal Resistive Indexes Combined With Echocardiographic Parameters: An Experimental Study
title_sort non-invasive early prediction of septic acute kidney injury by doppler-based renal resistive indexes combined with echocardiographic parameters: an experimental study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671634/
https://www.ncbi.nlm.nih.gov/pubmed/34926487
http://dx.doi.org/10.3389/fmed.2021.723837
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