ArticleAmerican journal of translational research2025
Predictive value of renal resistive index and urinary neutrophil gelatinase-associated lipocalin for acute pancreatitis-associated renal injury and renal replacement therapy efficacy.
Article in American journal of translational research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the predictive value of Renal Resistive Index (RRI) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) for acute pancreatitis (AP)-associated acute kidney injury (AKI) and the efficacy of continuous renal replacement therapy (CRRT).
methodsA retrospective analysis was conducted on 251 patients with AP treated between July 2022 and May 2024. The patients were divided into an AKI group (145 cases) and a non-AKI group (106 cases) based on the occurrence of AKI. Clinical data and laboratory indicators, including RRI, uNGAL, serum creatinine (SCr), and blood urea nitrogen (BUN) were collected and compared between the two groups. Independent risk factors for AKI were identified using multivariate logistic regression, and receiver operating characteristic (ROC) curves were generated to assess predictive performance. Among the AKI patients who received CRRT, treatment response was evaluated by reductions in SCr, BUN, and Cystatin C (CysC), dividing patients into an effective group (74 cases) and an ineffective group (71 cases). Logistic regression model was used to identify independent predictors of CRRT efficacy, and ROC curves were applied to evaluate the predictive performance of relevant factors.
resultsCompared with the non-AKI group, the AKI group exhibited significantly higher RRI (0.83 vs. 0.61, P<0.001), uNGAL (110.32 ng/mL vs. 77.89 ng/mL, P<0.001), and SCr (84.15 μmol/L vs. 72.99 μmol/L, P<0.001). C-reactive protein (CRP) also showed a statistically significant difference (P=0.010). High uNGAL (OR=13.378, P<0.001), RRI (OR=16.246, P<0.001), and SCr (OR=3.138, P=0.002) levels were protective factors against AKI in AP patients. In patients undergoing CRRT, diabetes (OR=5.464, P=0.014), elevated uNGAL (OR=7.824, P=0.001), RRI (OR=11.556, P<0.001), and white blood cell count (WBC, OR=9.682, P<0.001) were independent risk factors for poor treatment response. ROC curve analysis showed that RRI (AUC=0.855) and uNGAL (AUC=0.804) had high predictive values for CRRT efficacy.
conclusionRRI, uNGAL, SCr, and CRP are valuable predictors of AP-associated AKI. Among patients receiving CRRT, diabetes, elevated uNGAL, high RRI, and elevated WBC are associated with reduced treatment efficacy.
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