Y Coban, D Yildizdas, OO Horoz, N Aslan, AK Bayazit

Abstract

The purpose of this study is to assess the predictive ability of renal resistive index (RRI) based on a comparison of RRI measurement values with the Kidney Disease: Improving Global Outcomes (KDIGO) stages in critically ill children. This prospective study included 56 paediatric intensive care patients at high risk of kidney injury, and was conducted between June 2018 and September 2019. The mean age of the 56 study patients was 4.8±5.4 years, with an F/M ratio of 23/33. There were 12 patients in the group without kidney injury based on the KDIGO criteria, and 24 patients with KDIGO stage I, 12 patients with stage II and eight patients with stage III. The mean left kidney resistive index (RI) was 0.68±0.006 in the group without kidney injury according to the KDIGO criteria, 0.59±0.15 in the stage I group, 0.58±0.27 in the stage II group and 0.65±0.06 in the stage III group, while the mean right kidney RI was 0.68±0.10, 0.58±013, 0.57±0.02 and 0.65±0.07, respectively. A cut-off point of <0.66 for the left kidney RI had a sensitivity of 92%, a specificity of 72%, and a positive likelihood ratio of 3.4 in detecting all kidney injuries according to KDIGO. A cut-off point of <0.68 for the right kidney RI had a sensitivity of 83%, a specificity of 82% and a positive likelihood ratio of 4.58. The present study found RRI to be highly predictive in the early detection of KDIGO stages I and II in critically ill children.