• Renske Wiersema, Thomas Kaufmann, Hilde N van der Veen, Robbert J de Haas, Franssen Casper F M CFM University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, the Netherlands., Jacqueline Koeze, van der Horst Iwan C C ICC Department of Intensive Care, Maastricht University Medical Center+, Maastricht University, Maastricht, the Netherlands., Frederik Keus, and SICS Study Group.
• University of Groningen, University Medical Center Groningen, Department of Critical Care, Groningen, the Netherlands. Electronic address: r.wiersema@umcg.nl.
• J Crit Care. 2020 Oct 1; 59: 57-62.

Background And PurposeRenal Resistive Index (RRI) and Venous Impedance Index (VII) might be of additional value for diagnosing Acute Kidney Injury (AKI). The purpose of this study was to assess the diagnostic accuracy of RRI and VII for AKI.Materials And MethodsIn the prospective Simple Intensive Care Studies-II (NCT03577405), we measured RRI and VII in acutely admitted adult intensive care patients within 24 h of admission. AKI was defined by the Kidney Disease Improving Global Outcome (KDIGO) criteria. The primary outcome was persistent AKI, defined as non-resolved AKI on day three. We tested specificity, sensitivity and diagnostic accuracy of both RRI and VII for persistent AKI.ResultsIn total, 371 patients were included of whom 123 patients (33%) had persistent AKI. RRI and VII did not differ between patients with and those without persistent AKI (p = .08 and p = .59). RRI had a moderate specificity (72%, 95%CI 66-78%) and low sensitivity (32%, 95%CI 24-41%) and VII had high sensitivity (93%, 95%CI 85-98%) and low specificity (11%, 95%CI 6-16%) for persistent AKI. Overall diagnostic accuracy of RRI and VII was moderate.ConclusionsIn acutely admitted critically ill patients, measures of renal perfusion by renal ultrasound were not different between patients with and without AKI, and show limited diagnostic accuracy for AKI. Registered:NCT03577405.Copyright © 2020. Published by Elsevier Inc.

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