Renal Resistive Index as a Predictor of Acute Kidney Injury and Evaluation of Fluid Administration in Sepsis

Tanta University45 enrolled

Overview

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

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 Type

OBSERVATIONAL

Enrollment

Conditions

Renal Resistive Index Acute Kidney Injury Sepsis

Interventions

Renal resistive indexDIAGNOSTIC_TEST

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.

Eligibility

Sex: ALLMin age: 21 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age over 21 years * meet Sepsis 3 criteria (potential source of infection , host response and organ dysfunction) but not in septic shock. Exclusion Criteria: * patients during pregnancy. * patients with hepatorenal syndrome. * Poor abdominal echogenicity eg.(morbid obesity ,increase intra abdominal pressure ) * Severe acute or chronic renal insufficiency . * Dialysis dependency. * Renal transplantation. * Known renal artery stenosis. * Mono-kidney, kidney tumor, anatomic kidney abnormalities.

Locations (1)

Tanta University Hospitals

Tanta, Elgharbia, Egypt

RECRUITING

Outcomes

Primary Outcomes

Prediction of AKI development by renal resistance index (RRI)

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

Time frame: 7 days from admission

Secondary Outcomes

Evaluation of fluid administration

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) .

Time frame: 7 days from admission

Length of ICU stay

Length of ICU stay till discharge will be measured.

Time frame: 2 months from admission till discharge

cumulative fluid balance over 7 days

Cumulative fluid balance over 7 days and urine output (intake -output) will be measured.

Time frame: 7 days from admission

The incidence of 28 day mortality

The incidence of mortality will be measured at 28 day.

Time frame: 28 days from admission

Central Contacts

Safinaz A Aboelfetoh, MBBCh

CONTACT

00201148855752 noralamar34@gmail.com

Data from ClinicalTrials.gov

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