The Predictive Value of Renal Resistive Index Combined with Lactate for the Prognosis of Patients with Sepsis Complicated by Acute Kidney Injury
WANG Qunwen
GUO Maosong
GE Xin
ZHANG Shujun
Abstract：Objective To explore the predictive value of renal resistive index(RRI)combined with lactate for the prognosis of patients with sepsis complicated by acute kidney injury(AKI).Methods A total of 115 patients with sepsis complicated by AKI admitted to Wuxi Fifth People's Hospital from September 2022 to January 2025 were selected.According to the 28-day disease outcome after admission,they were divided into a good prognosis group(78 cases)and a poor prognosis group(37 cases).All patients underwent renal ultrasound to measure RRI,and lactate was detected using an enzyme-based electrode method.Compare the general clinical data,RRI,and lactic acid levels between the two groups.ROC curve analysis was used to evaluate the predictive value of RRI,lactate,and their combination for disease prognosis in patients with sepsis complicated by AKI.Multivariate Logistic stepwise regression was used to analyze influencing factors for disease prognosis in these patients.Results The poor prognosis group had higher APACHE Ⅱ scores,SOFA scores,blood uric acid,serum creatinine,and CRP levels,and lower serum albumin levels than the good prognosis group(P<0.05).The RRI and lactate levels in the poor prognosis group were higher than those in the good prognosis group(P<0.01).Multivariate Logistic stepwise regression analysis showed that APACHE Ⅱ score(OR=2.330,95%CI:1.349-4.026,P=0.002),SOFA score(OR=2.050,95%CI:1.249-3.367,P=0.005),blood uric acid(OR=2.467,95%CI:1.411-4.313,P=0.002),RRI(OR=2.878,95%CI:1.725-4.800,P<0.001),and lactate(OR=3.077,95%CI:1.733-5.465,P<0.001)were independent risk factors for disease prognosis in patients with sepsis complicated by AKI.ROC curve analysis showed that the AUC of RRI for predicting disease prognosis was 0.765,the AUC of lactate was 0.819,and the AUC of the combination of RRI and lactate was 0.937.The combined prediction AUC was significantly better than that of RRI or lactate alone(Z=10.126,9.759,P<0.01).Conclusion Elevated RRI and lactate levels are closely associated with poor prognosis in patients with sepsis complicated by AKI.Both RRI and lactate have certain predictive value for the prognosis of these patients,and their combination provides better predictive performance.
Keywords：renal resistive indexlactatesepsisacute kidney injuryprognosispredictive value
Publication Date：2025-09-20
Online Publishing Date：2025-09-29(First online date of this platform, not the publication date of the document)
Pages：6( 109-114 )