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Journal of critical care · Jun 2022
Multicenter StudyPerformance of renal Doppler to predict the occurrence of acute kidney injury in patients without acute kidney injury at admission.
- David Schnell, Aurélie Bourmaud, Marie Reynaud, Stéphane Rouleau, Hamid Merdji, Alexandra Boivin, Mourad Benyamina, François Vincent, Alexandre Lautrette, Christophe Leroy, Yves Cohen, Matthieu Legrand, Jérôme Morel, Jeremy Terreaux, and Michael Darmon.
- Réanimation polyvalente, CH Angoulême, Angoulême, France; Université de Strasbourg (UNISTRA), Faculté de Médecine, Hôpitaux universitaires de Strasbourg, Service de Réanimation, Nouvel Hôpital Civil, Strasbourg, France.
- J Crit Care. 2022 Jun 1; 69: 153983.
PurposeThis study aimed at evaluating the performance of Doppler-based resistive index (RI) and semi-quantitative evaluation of renal perfusion using color-Doppler (SQP) to predict de novo AKI in the subgroup of critically ill patients without AKI at admission.MethodsThis study is an ancillary analysis of a prospective multicenter cohort study. Consecutive ICU patients requiring mechanical ventilation were included. Renal Doppler was performed at ICU admission. The diagnostic performance of RI and SQP to predict de novo AKI at day 3 was evaluated.ResultsAmong the 371 patients of the prospective cohort, 118 without AKI at study inclusion were included. Thirty-four patients (29%) developed an AKI. Neither RI (0.64 UI [0.57-0.70] vs 0.67 [0.62-0.70] in no AKI and de novo AKI group respectively, p = 0.177) nor SQP (2 [2, 3] vs 2 [1-3] in no AKI and de novo AKI group respectively, p = 0.061) were associated with AKI occurrence. Overall performance in predicting de novo AKI was null to poor with area under ROC curve of respectively 0.60 (95% CI 0.49-0.65) and 0.58 (95% CI 0.47-0.60) for RI and SQP. Similar results were obtained after adjustment for confounders.ConclusionsThese results confirm the poor performance of Doppler-based indices in predicting renal prognosis of ICU patients.Copyright © 2022 Elsevier Inc. All rights reserved.
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