The value of bedside renal ultrasound in predicting acute kidney injury in patients with multiple injuries

Abstract:

Objective: To explore the predictive value of renal ultrasound for acute kidney injury in patients with multiple injuries. Method: Patients with multiple injuries admitted to the emergency intensive care unit of the Affiliated Hospital of Nantong University from August 2018 to December 2020 were enrolled in our study. Renal blood grades and renal resistance index（RRI） were assessed by bedside ultrasound. Patients were divided into acute kidney injury（AKI） group and non-AKI group. Firstly，we investigated the correlation between ultrasound indexes and traditional renal indexes，and further detected the value of renal ultrasound indexes in predicting AKI diagnosis and outcomes. Results: Compared with non-AKI group, renal blood flow of AKI group was significantly decreased（P<0.001），and RRI was significantly increased（0.802±0.077 vs. 0.628±0.035，P<0.05）. RRI at admission had a significant correlation with the worst creatinine during the hospitalization（｜r｜=0.687），and was consistent with the serum biomarker neutrophil gelatinase associated lipids transport proteins（|r|=0.579）. ROC curve analysis further confirmed that the area under ROC was 0.984，and the cut-off value was 0.675，indicating that the diagnosis sensitivity and specificity were 90.9% and 95.7% separately. Conclusion: Renal blood flow and RRI during the hospitalization are sensitive indicators for predicting the occurrence of AKI in patients with multiple injuries，thus providing a basis for appropriate renal protective measures and blood purification strategies，which could be used as a routine monitoring item.