The Correlation Studies Between Kidney Hemodynamic Changes And Acute Kidney Injury In Patients With Traumatic Brain Surgery By The CDFI

Objective:The study focuses on the early warning index of renal hemodynamics in acute kidney injury of traumatic brain injury patients and investigate renal hemodynamic parameters associated with changes in renal function, providing clinical evidence for early diagnosis and treatment of postoperative acute kidney injury (AKI).Methods:51cases of traumatic brain injury patients included in this study. According to2007network expert group of acute kidney injury (AKIN) published diagnostic criteria, the study cases were divided into non-AKI group (n=31) and AKI group (n-20). Prior of the operation and1,4,9,16,24,48h after the operation, Color Doppler flow imaging (CDFI) was adopted to monitor renal blood flow dynamics of interlobar artery, and measure the artery Peak systolic velocity (PSV), End-diastolic velocity (EDV), Resistance index (RI). Meanwhile blood samples were collected at the same time to detect the renal function, including Creatinine (Crea), Blood Urea Nitrogen (BUN), Uric Acid (UA). According to the distribution, t test or nonparametric rank sum test were used to compare between groups. The relationship between variables was analyzed by linear correlation and linear regression, coefficient r and linear regression equation were calculated. The parameter P <0.05was considered statistically significant. By means of Logistic regression analysis, we investigated the risk factors of AKI, and established a predictive model. We assessed the discrimination of our model using the receiver operating characteristic (ROC) curve. The relationship between the single independent risk factor and AKI was depicted with an ROC curve.Results:1. Compared with non-AKI group, AKI group were more older and undergoing longer operative time (P<0.05).2. Preoperative of Crea, Urea, UA in the Non-AKI group and AKI group were no statistically significant differences (P>0.05). Compared with preoperative, postoperative9-48h Crea and BUN were increased in non-AKI group, postoperative9-48h Crea was increased, postoperative4-48h BUN was increased,9,16h UA was increased in AKI group (P<0.05).3. Preoperative of PSV, EDV, RI in the Non-AKI group and AKI group were no statistically significant differences (P>0.05). Compared with preoperative, postoperative1,4h PSV was increased,1-16h EDV was decreased,1-48h RI was increased in non-AKI group, postoperative1h PSV was increased, postoperative1-48h EDV was decreased,148h RI was increased in AKI group (P<0.05).4. According correlation analysis, EDV and Crea, BUN, UA were negatively correlated, RI and Crea, BUN, UA were positive correlated (P<0.05).5. Logistic regression analysis:After univariate analysis, age, operative time, postoperative1h Crea, postoperative1h EDV, postoperative1h RI were correlated with AKI, P<0.05; then these factors will be analyzed by multivariate regression analysis, the results of age and postoperative1h RI were correlated with AKI, P<0.05.6. The area under the receiver-operating characteristic (ROC) curve for diagnosis of AKI was0.805with90.00%sensitivity and67.70%specificity, greater than Crea, Urea, UA.Conclusion:There was a correlation between acute renal injury and the age, surgery time in traumatic brain injury patient. Renal interlobar artery RI was positively correlated with Crea, Urea and UA. Renal interlobar artery EDV was negatively correlated with Crea, Urea and UA. Color Doppler renal blood flow imaging RI seems to be an important index to early predict acute kindey injury in traumatic brain injury patients...