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| Doppler-based renal resistive index for the assessment of acute kidney injury in major trauma patients |
| Zhu Jian-gang，Gao Yu-zhi，Ye Li-gang，Liu Zhi-hai，Zhang Mao |
| ntensive Care Unit，the First Hospital of Jiaxing，Jiaxing 314000，China |
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Abstract Objective The objective of this study was to test Doppler-based renal resistive in⁃ dex（RRI）for the assessment of acute kidney injury in major trauma patients. Methods This was a pro⁃ spective observational study in emergency intensive care unit（EICU）in a teaching university hospital. From December 2013 to February 2014，a total of 44 major trauma patients were enrolled. Measurements of hemodynamic parameters and Doppler-based RRI were obtained at the first 7 days from admission to the EICU. Injury severity score（ISS）, Acute Physiology and Chronic Health Evaluation system （APACHE）Ⅱ，Glasgow coma score（GCS），ICU length of stay，the duration of ventilator support wererecorded. All patients were divided into AKI group and no-AKI group. The above indicators were statisti⁃ cally compared between the two groups. We drew the receiver operating characteristic（ROC）curves of RRI to judge AKI and determined the best critical points of RRI to judge AKI at the first 7 days from ad⁃ mission to the EICU，then compared their areas under the curves by z test. The indices correlated signifi⁃ cantly with RRI were filtrated by stepwise linear regression analysis. Results Among 44 patients，there were 8 patients in AKI group and 36 patients in no-AKI group. Patients in AKI group had higher RRI than those in no-AKI group. The areas under the ROC curves of RRI to judge AKI were 0.731±0.134， 0.773±0.121，0.843±0.075，0.808±0.118，0.769±0.114，0.840±0.121，0.811±0.118 separately at the first 7 days from admission to the EICU，and they were all more than 0.5 significantly. There were no signifi⁃ cant differences among them. Age and AKI stage correlated significantly with RRI at the first 7 days from admission to the EICU. Mean arterial pressure，hear rate，arterial partial pressure of oxygen and pulse pressure correlated significantly with RRI at some days. Conclusion Doppler- based RRI correlated significantly with AKI in major trauma patients，and reflected AKI severity to some extend. Dopplerbased RRI can be used as a beneficial supplement method for routine kidney function evaluation.
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Received: 12 March 2016
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Corresponding Authors:
Zhang Mao，E-mail: zmhz@hotmail. com
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Zhongguancun, 