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Conference Paper: Use of Doppler ultrasound renal resistive index and neutrophil gelatinase-associated lipocalin in prediction of acute kidney injury in patients with septic shock

TitleUse of Doppler ultrasound renal resistive index and neutrophil gelatinase-associated lipocalin in prediction of acute kidney injury in patients with septic shock
Authors
Issue Date2011
PublisherBioMed Central
Citation
The 31st International Symposium on Intensive Care and Emergency Medicine, Brussels, Belgium. 22-25 March 2011. In Critical Care, 2011, v. 15 suppl 1, p. 539, abstract no. P108 How to Cite?
AbstractINTRODUCTION: Acute kidney injury (AKI) is common in septic shock and there is no good marker to predict it. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel renal biomarker showing promising results in prediction of AKI in patients across diff erent clinical settings. Another potential marker is the resistive index (RI) of renal interlobar artery (calculated as (peak systolic velocity – end diastolic velocity) / peak systolic velocity), which has been shown to be useful in identifying those who will develop AKI in patients with septic shock. The aim of this study is to evaluate the usefulness of RI and NGAL in the early detection of AKI. METHODS: A prospective, observational study in a 20-bed medical/surgical ICU of a university teaching hospital. All patients with septic shock were recruited, excluding those with chronic renal failure (serum creatinine >120 μmol/l). Within the fi rst 24 hours after the introduction of vasopressor, urine and serum were collected for NGAL measurement and RI was determined by two independent operators. The occurrence of AKI was measured at day 3, according to RIFLE criteria. RI and NGAL were compared between patients with (RIFLE-F) and without (RIFLE-0/R/I) AKI. RESULTS: During the period from August to November 2010, 20 patients (age 58 ± 16) with septic shock were recruited. Eleven patients were classifi ed as having AKI. No signifi cant diff erence in baseline characteristics such as APACHE II score and baseline creatinine was shown at enrollment. RI, serum-NGAL and urine-NGAL were all higher in patients with AKI (RI: 0.749 ± 0.0697 (mean ± SD) vs. 0.585 ± 0.0983, P <0.001; serum-NGAL: 2,182 ± 838 ng/ml (mean ± SD) vs. 1,075 ± 1,006, P = 0.015; urine-NGAL: 2,009 ± 3,370 vs. 993 ± 1,789 (median ± IQR), P = 0.025). Area under the ROC curve for RI and serum-NGAL was 0.909 (±0.088, P = 0.002) and 0.808 (±0.113, P = 0.02), respectively. For RI, using 0.65 as the cut-off , sensitivity and specifi city was 1 and 0.89, respectively. For serum-NGAL, using a cut-off of 1,200 ng/ml, it had a sensitivity of 1 and specifi city of 0.67. Inter-observer diff erence of RI was low (0.0015 ± 0.0074 (mean ± SD)). CONCLUSIONS: Doppler ultrasound renal RI is non-invasive, rapidly available and easily reproducible, and is at least as good as NGAL as a predictor of AKI in patients with septic shock.
DescriptionThis journal suppl. contain meeting abstracts of the 31st International Symposium on Intensive Care and Emergency Medicine
Poster Presentation
Persistent Identifierhttp://hdl.handle.net/10722/140861
ISSN
2015 Impact Factor: 4.95
2015 SCImago Journal Rankings: 2.002
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorNgai, CWen_US
dc.contributor.authorLam, MFen_US
dc.contributor.authorLo, SHen_US
dc.contributor.authorCheung, CWen_US
dc.contributor.authorChan, WMen_US
dc.date.accessioned2011-09-23T06:20:23Z-
dc.date.available2011-09-23T06:20:23Z-
dc.date.issued2011en_US
dc.identifier.citationThe 31st International Symposium on Intensive Care and Emergency Medicine, Brussels, Belgium. 22-25 March 2011. In Critical Care, 2011, v. 15 suppl 1, p. 539, abstract no. P108en_US
dc.identifier.issn1466-609X-
dc.identifier.urihttp://hdl.handle.net/10722/140861-
dc.descriptionThis journal suppl. contain meeting abstracts of the 31st International Symposium on Intensive Care and Emergency Medicine-
dc.descriptionPoster Presentation-
dc.description.abstractINTRODUCTION: Acute kidney injury (AKI) is common in septic shock and there is no good marker to predict it. Neutrophil gelatinase-associated lipocalin (NGAL) is a novel renal biomarker showing promising results in prediction of AKI in patients across diff erent clinical settings. Another potential marker is the resistive index (RI) of renal interlobar artery (calculated as (peak systolic velocity – end diastolic velocity) / peak systolic velocity), which has been shown to be useful in identifying those who will develop AKI in patients with septic shock. The aim of this study is to evaluate the usefulness of RI and NGAL in the early detection of AKI. METHODS: A prospective, observational study in a 20-bed medical/surgical ICU of a university teaching hospital. All patients with septic shock were recruited, excluding those with chronic renal failure (serum creatinine >120 μmol/l). Within the fi rst 24 hours after the introduction of vasopressor, urine and serum were collected for NGAL measurement and RI was determined by two independent operators. The occurrence of AKI was measured at day 3, according to RIFLE criteria. RI and NGAL were compared between patients with (RIFLE-F) and without (RIFLE-0/R/I) AKI. RESULTS: During the period from August to November 2010, 20 patients (age 58 ± 16) with septic shock were recruited. Eleven patients were classifi ed as having AKI. No signifi cant diff erence in baseline characteristics such as APACHE II score and baseline creatinine was shown at enrollment. RI, serum-NGAL and urine-NGAL were all higher in patients with AKI (RI: 0.749 ± 0.0697 (mean ± SD) vs. 0.585 ± 0.0983, P <0.001; serum-NGAL: 2,182 ± 838 ng/ml (mean ± SD) vs. 1,075 ± 1,006, P = 0.015; urine-NGAL: 2,009 ± 3,370 vs. 993 ± 1,789 (median ± IQR), P = 0.025). Area under the ROC curve for RI and serum-NGAL was 0.909 (±0.088, P = 0.002) and 0.808 (±0.113, P = 0.02), respectively. For RI, using 0.65 as the cut-off , sensitivity and specifi city was 1 and 0.89, respectively. For serum-NGAL, using a cut-off of 1,200 ng/ml, it had a sensitivity of 1 and specifi city of 0.67. Inter-observer diff erence of RI was low (0.0015 ± 0.0074 (mean ± SD)). CONCLUSIONS: Doppler ultrasound renal RI is non-invasive, rapidly available and easily reproducible, and is at least as good as NGAL as a predictor of AKI in patients with septic shock.-
dc.languageengen_US
dc.publisherBioMed Central-
dc.relation.ispartofCritical Careen_US
dc.rightsCritical Care. Copyright © BioMed Central Ltd.-
dc.titleUse of Doppler ultrasound renal resistive index and neutrophil gelatinase-associated lipocalin in prediction of acute kidney injury in patients with septic shocken_US
dc.typeConference_Paperen_US
dc.identifier.emailLam, MF: feimflam@hku.hken_US
dc.identifier.emailCheung, CW: cheucw@hku.hken_US
dc.identifier.emailChan, WM: drchanwm@hkucc.hku.hk-
dc.identifier.authorityCheung, CW=rp00244en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1186/cc9528-
dc.identifier.pmcidPMC3061738-
dc.identifier.hkuros193491en_US
dc.identifier.hkuros196643-
dc.identifier.volume15-
dc.identifier.issuesuppl 1-
dc.identifier.spage539, abstract no. P108-
dc.identifier.epage539, abstract no. P108-
dc.description.otherThe 31st International Symposium on Intensive Care and Emergency Medicine, Brussels, Belgium. 22-25 March 2011. In Critical Care, 2011, v. 15 suppl 1, p. 539, abstract no. P108-

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