Kidney Res Clin Pract > Volume 42(4); 2023 > Article |
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Funding
This study was supported by the Young Investigator Research Grant from the Korean Society of Nephrology (KSN 2019).
Variable | Healthy group (n = 17) | CKD group (n = 18) | S-AKI group (n = 23) | p-value |
---|---|---|---|---|
Age (yr) | 53 (46–68) | 43 (35–52)* | 73 (65–87)*,† | <0.001 |
Female sex | 5 (29.4) | 9 (50.0) | 9 (39.1) | 0.46 |
Comorbidity | ||||
Hypertension | 9 (52.9) | 15 (83.3) | 14 (60.9) | 0.14 |
Diabetes mellitus | 2 (11.8) | 10 (55.6) | 14 (60.9) | 0.005 |
Coronary heart disease | 0 (0) | 0 (0) | 3 (13.0) | 0.09 |
Heart failure | 1 (5.9) | 0 (0) | 6 (26.1) | 0.03 |
Liver disease | 0 (0) | 2 (11.1) | 1 (4.3) | 0.32 |
Chronic lung disease | 1 (5.9) | 1 (5.6) | 2 (8.7) | 0.91 |
Charlson comorbidity index | 0 (0–1) | 2 (0–2) | 2 (1–3) | <0.001 |
Baseline renal function | ||||
Creatinine (mg/dL) | 0.8 (0.6–0.9) | 1.7 (0.9–3.2) | 2.2 (1.1–2.9)a | 0.004 |
eGFR (mL/min/1.73 m2) | 98.8 (92.7–108.8) | 45.2 (15.9–99.3) | 24.3 (14.4–62.3)a,* | 0.003 |
Renal length (cm) | 10.7 (10.2–11.2) | 10.7 (10.3–11.4) | 10.3 (9.8–11.3) | 0.52 |
Drug use | ||||
RAS blocker | 4 (23.5) | 15 (83.3) | 7 (30.4) | <0.001 |
NSAID | 1 (5.9) | 0 (0) | 0 (0) | 0.29 |
CEUS parameter | ||||
Peak enhancement (×103 AU) | 19.0 (13.6–42.0) | 13.0 (9.7–24.6) | 23.2 (8.5–33.3) | 0.54 |
Wash-in AUC (×103 AU) | 117.0 (60.7–156.7) | 94.2 (65.3–183.6) | 136.8 (87.8–201.3) | 0.57 |
Rise time (sec) | 7.6 (6.2–9.5) | 9.8 (7.6–12.5) | 10.0 (8.2–16.8)* | 0.03 |
Mean transit time (sec) | 69.4 (48.5–107.5) | 59.6 (53.2–86.4) | 65.4 (48.9–92.2) | 0.84 |
Time to peak (sec) | 11.7 (10.5–13.5) | 15.3 (12.7–17.3)* | 15.8 (12.5–21.1)* | 0.008 |
Wash-in rate (×103 AU) | 3.3 (2.2–8.1) | 2.1 (1.5–4.2) | 3.2 (1.1–6.1) | 0.28 |
Wash-in perfusion index (×103 AU) | 12.1 (8.5–27.3) | 8.7 (6.4–16.3) | 16.4 (5.4–21.4) | 0.55 |
Wash-out AUC (×103 AU) | 246.3 (147.2–307.6) | 249.4 (169.9–532.9) | 314.3 (229.1–571.7) | 0.25 |
Fall time (sec) | 17.4 (10.9–21.6) | 22.1 (15.3–33.5) | 22.3 (17.2–40.3) | 0.09 |
Wash-out rate (×103 AU) | 1.1 (0.9–3.3) | 0.7 (0.3–1.3) | 0.7 (0.3–2.8) | 0.19 |
Data are expressed as median (interquartile range), number (%), or mean ± standard deviation.
AU, arbitrary unit; AUC, area under the curve; CEUS, contrast-enhanced ultrasonography; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; NSAID, non-steroidal anti-inflammatory drug; RAS, renin-angiotensin system; RRT, renal replacement therapy; S-AKI, sepsis-associated acute kidney injury.
Variable |
Parameter relating to microvascular blood volume and flow |
Parameter relating to microvascular flow velocity |
||||||||
---|---|---|---|---|---|---|---|---|---|---|
Peak enhancement | Wash-in AUC | Wash-in rate | Wash-in perfusion index | Wash-out AUC | Wash-out rate | Rise time | Mean transit time | Time to peak | Fall time | |
Age | 0.03 | 0.17 | −0.01 | 0.03 | 0.14 | −0.09 | 0.22 | 0.05 | 0.19 | 0.17 |
Sex | 0.13 | 0.17 | 0.16 | 0.14 | 0.25 | 0.04 | 0.13 | −0.14 | 0.02 | 0.28 |
Hypertension | −0.21 | −0.23 | −0.13 | −0.20 | −0.21 | −0.13 | 0.12 | −0.03 | 0.10 | 0.05 |
Diabetes mellitus | −0.13 | −0.09 | −0.11 | −0.13 | −0.04 | −0.12 | −0.10 | 0.04 | −0.17 | −0.05 |
Heart failure | 0.19 | 0.16 | 0.16 | 0.19 | 0.07 | 0.13 | 0.13 | 0.06 | 0.21 | −0.03 |
Charlson comorbidity index | 0.02 | −0.02 | 0.02 | 0.02 | −0.11 | 0.02 | −0.10 | 0.03 | −0.05 | −0.19 |
Renal length | 0.09 | 0.01 | 0.14 | 0.09 | 0.09 | 0.14 | −0.15 | −0.10 | −0.22 | −0.13 |
At the time of RRT commencement | ||||||||||
SOFA | 0.13 | 0.05 | 0.21 | 0.14 | 0.19 | 0.19 | −0.24 | −0.13 | −0.36 | −0.01 |
Lactate level | −0.10 | 0.06 | −0.12 | −0.08 | 0.17 | −0.12 | 0.36 | 0.19 | 0.28 | 0.49* |
Septic shock | 0.17 | 0.18 | 0.15 | 0.17 | 0.29 | 0.13 | −0.13 | −0.03 | −0.21 | 0.07 |
Urine output | 0.18 | 0.20 | 0.10 | 0.18 | 0.06 | 0.13 | −0.21 | −0.15 | −0.20 | −0.20 |
At the time of CEUS | ||||||||||
Mean blood pressure | −0.24 | −0.20 | −0.20 | −0.23 | −0.23 | −0.19 | −0.01 | −0.28 | −0.08 | 0.05 |
RAS blocker | −0.05 | 0.14 | −0.16 | −0.04 | 0.19 | −0.19 | 0.30 | −0.27 | 0.19 | 0.37 |
Urine output | 0.36 | 0.41 | 0.24 | 0.37 | 0.35 | 0.21 | −0.13 | −0.15 | −0.18 | −0.05 |
Laboratory results | ||||||||||
Hemoglobin | −0.25 | −0.20 | −0.19 | −0.25 | −0.18 | −0.25 | 0.04 | −0.07 | −0.03 | 0.11 |
Albumin | −0.20 | −0.10 | −0.25 | −0.20 | −0.12 | −0.23 | 0.31 | 0.17 | 0.35 | 0.14 |
C-reactive protein | 0.03 | 0.23 | −0.09 | 0.05 | 0.34 | −0.15 | 0.17 | 0.41* | 0.11 | 0.15 |
Total bilirubin | 0.05 | 0.02 | 0.16 | 0.05 | −0.09 | 0.16 | 0.03 | 0.20 | 0.09 | −0.09 |
Data are expressed as correlation coefficient derived from the Pearson correlation analysis.
AUC, area under the curve; CEUS, contrast-enhanced ultrasonography; RAS, renin-angiotensin system; RRT, renal replacement therapy; S-AKI, sepsis-associated acute kidney injury; SOFA, Sequential Organ Failure Assessment.
Data are expressed as median (interquartile range) or number (%).
CEUS, contrast-enhanced ultrasonography; eGFR, estimated glomerular filtration rate; RAS, renin-angiotensin system; RRT, renal replacement therapy; S-AKI, sepsis-associated acute kidney injury; SOFA, Sequential Organ Failure Assessment.
Variable |
Univariate |
Multivariatea | ||
---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | |
Age | 0.97 (0.90–1.04) | 0.32 | 0.94 (0.85–1.05) | 0.27 |
Female sex | 1.50 (0.26–8.58) | 0.65 | 3.61 (0.29–44.94) | 0.32 |
Charlson comorbidity index | 0.84 (0.54–1.30) | 0.43 | 0.93 (0.57–1.51) | 0.76 |
SOFA score | 1.19 (0.90–1.58) | 0.23 | 1.08 (0.78–1.50) | 0.64 |
CEUS parameters (per 1 × 103 AU) | ||||
Peak enhancement | 1.09 (1.00–1.18) | 0.05 | 1.08 (0.99–1.17) | 0.09 |
Wash-in AUC | 1.02 (1.00–1.03) | 0.07 | 1.02 (1.00–1.04) | 0.07 |
Wash-in perfusion index | 1.14 (1.00–1.29) | 0.05 | 1.12 (0.98–1.27) | 0.09 |
Wash-out AUC | 1.01 (1.00–1.01) | 0.08 | 1.01(1.00–1.01) | 0.08 |
Jungho Shin
https://orcid.org/0000-0001-9755-3100
Jin Ho Hwang
https://orcid.org/0000-0003-0829-0922
Sung Bin Park
https://orcid.org/0000-0002-4155-9260
Su Hyun Kim
https://orcid.org/0000-0001-8608-9525