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The Ultrasound Journal

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01-12-2021 | Acute Kidney Injury | Original article

Renal resistive index is associated with acute kidney injury in COVID-19 patients treated in the intensive care unit

Authors: Mårten Renberg, Olof Jonmarker, Naima Kilhamn, Claire Rimes-Stigare, Max Bell, Daniel Hertzberg

Published in: The Ultrasound Journal | Issue 1/2021

Abstract

Background

Renal resistive index (RRI) is a promising tool for the assessment of acute kidney injury (AKI) in critically ill patients in general, but its role and association to AKI among patients with Coronavirus disease 2019 (COVID-19) is not known.

Objective

The aim of this study was to describe the pattern of RRI in relation to AKI in patients with COVID-19 treated in the intensive care unit.

Methods

In this observational cohort study, RRI was measured in COVID-19 patients in six intensive care units at two sites of a Swedish University Hospital. AKI was defined by the creatinine criteria in the Kidney Disease Improving Global Outcomes classification. We investigated the association between RRI and AKI diagnosis, different AKI stages and urine output.

Results

RRI was measured in 51 patients, of which 23 patients (45%) had AKI at the time of measurement. Median RRI in patients with AKI was 0.80 (IQR 0.71–0.85) compared to 0.72 (IQR 0.67–0.78) in patients without AKI (p = 0.004). Compared to patients without AKI, RRI was higher in patients with AKI stage 3 (median 0.83, IQR 0.71–0.85, p = 0.006) but not in patients with AKI stage 1 (median 0.76, IQR 0.71–0.83, p = 0.347) or AKI stage 2 (median 0.79, min/max 0.79/0.80, n = 2, p = 0.134). RRI was higher in patients with an ongoing AKI episode compared to patients who never developed AKI (median 0.72, IQR 0.69–0.78, p = 0.015) or patients who developed AKI but had recovered at the time of measurement (median 0.68, IQR 0.67–0.81, p = 0.021). Oliguric patients had higher RRI (median 0.84, IQR 0.83–0.85) compared to non-oliguric patients (median 0.74, IQR 0.69–0.81) (p = 0.009). After multivariable adjustment, RRI was independently associated with AKI (OR for 0.01 increments of RRI 1.22, 95% CI 1.07–1.41).

Conclusions

Critically ill COVID-19 patients with AKI have higher RRI compared to those without AKI, and elevated RRI may have a role in identifying severe and oliguric AKI at the bedside in these patients.

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Title: Renal resistive index is associated with acute kidney injury in COVID-19 patients treated in the intensive care unit
Authors: Mårten Renberg
Olof Jonmarker
Naima Kilhamn
Claire Rimes-Stigare
Max Bell
Daniel Hertzberg
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keywords: Acute Kidney Injury
Care
COVID-19
Acute Kidney Injury
Published in: The Ultrasound Journal / Issue 1/2021
Electronic ISSN: 2524-8987
DOI: https://doi.org/10.1186/s13089-021-00203-z

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