The Role of Renal Resistive Index (RI) in Predicting Acute Kidney Injury Progression in Intensive Care Clinic
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorGulhane Training and Research Hospital
About this trial
Acute kidney injury(AKI) is defined in the KDIGO guidelines as a ≥0.3 mg/dL (≥26.5 micromol/L) increase in serum creatinine in the previous 48 hours or a ≥1.5-fold increase in serum creatinine from baseline, known or presumed to have occurred in the previous seven days, or a urine volume \<0.5 mL/kg/hour for six hours.
Given the high morbidity and mortality associated with AKI, many investigators are studying several novel biomarkers to detect AKI progression earlier, identify etiologies and predict outcomes. However, the utilisation of these novel biomarkers may be constrained by reimbursement considerations.
The renal resistive index (RRI) is a well-established metric for evaluating renal perfusion; however, its application in the context of AKI has been a subject of recent debate. While RRI has been utilised to demonstrate perfusion in acute and chronic renal diseases, particularly in conjunction with ultrasonography, its efficacy remains a subject of scientific discourse. In addition, Boddi reported that RRI is a strong indicator of mortality and a diagnostic marker, especially in patients with persistent AKI.
The present study aims to evaluate the appropriateness of using the RRI, a non-invasive procedure, to determine the progression of AKI stages and the need for renal replacement therapy in patients hospitalised in intensive care units.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Being over 18 years of age
Having KDIGO stage 1 or stage 2 acute kidney injury within the first 24 hours of admission
Disqualifiers
1. Patients who did not provide a consent form for participation in the study 2. Patients under 18 years of age 3. Pregnant women 4. Patients with postrenal acute kidney injury 5. Patients 24 hours after the diagnosis of acute kidney injury 6. Patients with acute kidney injury in the recovery period 7. Patients who were evaluated as KDIGO ABH stage 3 during hospitalization 8. Patients with a known history of renal artery stenosis 9. Patients with a diagnosis of cardiac arrhythmia 10. Patients with a diagnosis of chronic kidney disease and a glomerular filtration rate below 30 ml/min/1.73m2 11. Patients with intra-abdominal pressure above 20 mmHg 12. Patients with a hospitalization period of less than 24 hours
Trial population
Male and female patients over 18 years of age who met KDIGO ABH stage 1 or stage 2 criteria and were hemodynamically stable in the first 24 hours of admission to the Internal Medicine Intensive Care Unit of Gülhane Training and Research Hospital, University of Health Sciences.
Trial design
Design model
Cohort
Time perspective
Prospective
Treatments tested in this trial
renal resistive index with Doppler ultrasound
Diagnostic testRenal resistive index uses doppler ultrasonography which assesses blood flow velocity in the renal arteries. The Renal Resistive Index (RI) is calculated by substracting diastolic velocity from systolic velocity then dividing result by systolic velocity Where: Systolic velocity is the peak velocity of the blood flow during the systolic phase of the cardiac cycle. Diastolic velocity is the velocity of blood flow during the diastolic phase.
Treatment groups
No treatment groups listed
Trial outcomes
Primary outcomes
1
Akut kidney injury progression
Patients admitted to our intensive care clinic with a diagnosis of AKI stage 1-2(according to KDIGO staging) will have RI measurement with Doppler Ulsanography within the first 24 hours of admission. Patients will be followed up daily from the time of measurement until the end of the study period and their progression to AKI stage 3(according to KDIGO staging) will be recorded. Patients will be monitored throughout the study. A comparison will be made between the groups that developed AKI stage 3(according to KDIGO staging) and those that did not develop AKI stage 3 during the study.
Time frame
14 daysSecondary outcomes
1
14th day mortality rate
The mortality status of patients on the 14th day after ICU admission will be recorded. The relationship between RI value and 14-day mortality will be evaluated.
Time frame
14 days2
28th day mortality rate
The mortality status of patients on the 28th day after ICU admission will be recorded. The relationship between RI value and 28-day mortality will be evaluated.
Time frame
28 days3
Length of stay in the intensive care unit
The duration of stay in the ICU will be recorded for each patient. The association between RI value and length of ICU stay will be assessed.
Time frame
18 months4
Need for renal replacement therapy (RRT)
The requirement for RRT during ICU stay will be recorded according to KDIGO criteria. Patients who require RRT will be compared with those who do not, in terms of RI level.
Time frame
14 daysSponsors and contacts
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Source ClinicalTrials.gov