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ISSN 2448-8909 (Print)

2023, Number 8

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Med Crit 2023; 37 (8)

Renal resistive index as predictor of acute kidney injury in neurocritical patients with hypertonic saline solutions

Fuentes GAJ, Rodríguez ZC, Mendoza PE

Language: Spanish
References: 28
Page: 699-706
PDF size: 258.30 Kb.


ABSTRACT

Introduction: one of the main strategies in the management of intracranial hypertension (ICH) are hypertonic solutions, because of its osmolar effect and improving cerebral perfusion in order to limit brain damage. The present study focus on evaluate the relationship between renal resistive index (RRI) and the development of acute kidney injury (AKI) in neurocritical patients receiving hyperosmolar therapy with different concentrations of hypertonic saline solution. Material and methods: observational, analytical, prospective, cohort study. Two groups of patients were compared. The first one with ICH exposed to hyperosmolar solutions, the second group also with neurological pathologies, not exposed to osmotic agents. The proportion of patients who developed AKI in both groups was analyzed. Results: 66 patients, 32 in each arm. Age > 60 years was associated to risk for AKI (p = 0.05), as well as the presence of arterial hypertension (p = 0.003). 7.5% hypertonic saline was shown to be a risk factor for AKI (p = 0.009), as was hyperchloremia (p = 0.005). An RRI maintained ≤ 0.7 for 48 hours was associated with fewer cases of AKI (p < 0.001). Multivariate analysis showed that age > 60 years was a risk factor for AKI (p = 0.024). Conclusions: the contribution of the present study is the identification of an IRR > 0.7 as a marker of possible progression to kidney damage.


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