Abstract
Objective: To evaluate the predictive value of renal resistive index (RRI), inferior vena cava collapsibility index (IVCCI), and central venous pressure (CVP) to the incidence of acute kidney injury (AKI) in critically ill patients with risk of AKI in the intensive care unit (ICU).
Design: This study used an analytic observational study with a prospective cohort design.
Setting: The study was conducted in January 2025. The study used primary and secondary data (medical records) from patients in the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar.
Patients: The study included 54 patients who met the inclusion criteria, including 17 with AKI and 37 without AKI.
Measurements: Parameters measured included RRI, IVCCI, and CVP to predict AKI. In addition, urea and creatinine levels were also measured.
Results: RRI showed a strong, significant correlation with urea (r=0.724, p<0.001) and creatinine (r=0.738, p<0.001). Receiver operating characteristic (ROC) curve analysis indicated RRI had the highest predictive ability of AKI incidence (area under the curve [AUC] 0.96, sensitivity 94.1%, specificity 94.6%, p<0.001). RRI was also significantly correlated with AKI according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification, with the majority of patients with RRI≥0.75 in grades 1–3, whereas those with RRI<0.75 were in grade 0 (p<0.001). IVCCI showed no significant correlation; meanwhile, CVP showed only a weakly significant correlation to urea (r=0.273, p=0.048), with a low AUC value (0.63) and no significance (p>0.05) for AKI prediction.
Conclusions: RRI had a significant predictive value for the incidence of AKI in critically ill patients in the ICU and correlated with the severity of AKI based on the KDIGO classification. In contrast, IVCCI and CVP did not show a significant relationship with the incidence of AKI. Therefore, RRI can be used as a potential non-invasive tool for early detection and risk assessment of AKI in critically ill patients.
Muhammad Fauzi Saputra, Haizah Nurdin, Syamsul Hilal Salam, Syafri Kamsul Arif, Faisal Muchtar, Ari Santri Palinrungi
