Renal Resistive Index as a Predictor of Acute Kidney Injury and Evaluation of Fluid Administration in Sepsis
Study Details
Study Description
Brief Summary
We aim from this study to investigate the role of renal resistance index (RRI) in evaluation of Acute kidney injury development and fluid administration in sepsis patients considering the change in RRI values over 7 days from admission as a predictor of AKI development
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
Acute kidney injury (AKI) is one of the most common problems in critically ill patients in the clinic. AKI can be caused by various factors, such as hypovolemia, shock, major surgery, trauma, and heart failure, of which sepsis is the most common
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| AKI group Acute kidney injury (AKI) was defined according to the Kidney Disease Improving Global Outcome (KDIGO) classification using both creatinine and urine output criteria. The KDIGO guidelines define AKI as follows: Increase in serum creatinine by ≥0.3 mg/dL (≥26.5 micromol/L) within 48 hours, or Increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the prior seven days, or Urine volume <0.5 mL/kg/hour for six hours |
Diagnostic Test: Renal resistive index
The calculation formula for Renal resistive index (RRI) as follows :
(systolic peak flow velocity _ diastolic minimum flow velocity )/systolic peak flow velocity .
will be measured with ultrasound-Doppler using an abdominal curvilinear probe ultrasonography by two independent, trained sonographers (who will not be involved in patient care. After visualizing the kidney in ultrasound mode and checking for renal abnormalities, an arcuate or interlobar artery will be localized and three successive doppler measurements at different positions in the kidney (high, middle and low) will be performed, 3 times in each kidney. So a total number of 9 RRI values will be obtained in each kidney.
The median value of each section will be used and the 3 median values of each kidney will be averaged.
Other Names:
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| Non AKI group Patients who will no develop Acute kidney injury (AKI). |
Diagnostic Test: Renal resistive index
The calculation formula for Renal resistive index (RRI) as follows :
(systolic peak flow velocity _ diastolic minimum flow velocity )/systolic peak flow velocity .
will be measured with ultrasound-Doppler using an abdominal curvilinear probe ultrasonography by two independent, trained sonographers (who will not be involved in patient care. After visualizing the kidney in ultrasound mode and checking for renal abnormalities, an arcuate or interlobar artery will be localized and three successive doppler measurements at different positions in the kidney (high, middle and low) will be performed, 3 times in each kidney. So a total number of 9 RRI values will be obtained in each kidney.
The median value of each section will be used and the 3 median values of each kidney will be averaged.
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Prediction of AKI development by renal resistance index (RRI) [7 days from admission]
AKI was defined according to the Kidney Disease Improving Global Outcome (KDIGO) classification using both creatinine and urine output criteria. The KDIGO guidelines define AKI as follows Increase in serum creatinine by ≥0.3 mg/dL (≥26.5 micromol/L) within 48 hours, or Increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred within the prior seven days, or Urine volume <0.5 mL/kg/hour for six hours
Secondary Outcome Measures
- Evaluation of fluid administration [7 days from admission]
RRI and other hypoperfusion markers after fluid challenge and divided into responder to fluid (Time 1 F) and non responder with noradrenaline administration (Time 1 N) .
- Length of ICU stay [2 months from admission till discharge]
Length of ICU stay till discharge will be measured.
- cumulative fluid balance over 7 days [7 days from admission]
Cumulative fluid balance over 7 days and urine output (intake -output) will be measured.
- The incidence of 28 day mortality [28 days from admission]
The incidence of mortality will be measured at 28 day.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age over 21 years
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meet Sepsis 3 criteria (potential source of infection , host response and organ dysfunction) but not in septic shock.
Exclusion Criteria:
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patients during pregnancy.
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patients with hepatorenal syndrome.
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Poor abdominal echogenicity eg.(morbid obesity ,increase intra abdominal pressure )
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Severe acute or chronic renal insufficiency .
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Dialysis dependency.
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Renal transplantation.
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Known renal artery stenosis.
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Mono-kidney, kidney tumor, anatomic kidney abnormalities.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Tanta University Hospitals | Tanta | Elgharbia | Egypt | 31527 |
Sponsors and Collaborators
- Tanta University
Investigators
- Principal Investigator: Safinaz A Aboelfetoh, MBBCh, Anesthesiology, Faculty of Medicine, Tanta University, Egypt.
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 36264MS189/5/23