Protocol for a prospective observational study on the association of variables obtained by contrast-enhanced ultrasonography and sepsis-associated acute kidney injury

Abstract

IntroductionSepsis commonly results in acute kidney injury (AKI), whereas about 50% of AKI cases are due to sepsis. Sepsis-associated acute kidney injury (SA-AKI) increases morbidity and mortality especially among critically ill patients. This study aims to monitor renal microcirculation perfusion during sepsis using contrast-enhanced ultrasonography (CEUS), and to explore whether CEUS is useful for predicting the development of SA-AKI.Methods and analysisThis prospective observational study will enrol patients who were diagnosed with sepsis-3 definition. The total of septic or septic shock patients were stratified into AKI (including stages 1, 2 and 3) and non-AKI groups according to Kidney Disease Improving Global Outcomes criteria on days 0, 1, 2 and 7 after admission to the emergency intensive care unit, meanwhile, the CEUS technique will be performed to monitor renal microcirculation perfusion. A multivariable model including all CEUS variables were expected to create for predicting the development of AKI during sepsis. Ultrasonography results, demographic information, therapeutic interventions, survival outcomes, laboratory and other clinical datas will also be collected for further analysis.Ethics and disseminationThe study protocol was approved on 2 August 2017 by the Ethics Committee of Sir Run Run Shaw Hospital (Zhejiang University Medical College) (approval number: 2016C91401). The results will be published in a peer-reviewed journal and shared with the worldwide medical community within 2 years after the start of the recruitment.Trial registration numberISRCTN14728986

Evaluation of Contrast-Enhanced Ultrasound in Diagnosis of Acute Kidney Injury of Patients in Intensive Care Unit

“…In the present study, PI in the AKI group was lower than in the non-AKI group, which may be related to the decreased overall perfusion and persistent hypoperfusion in the injured kidney. 30 , 31 …”

Microbubble Functionalization with Platelet Membrane Enables Targeting and Early Detection of Sepsis‐Induced Acute Kidney Injury

“…Ultrasound imaging was used to measure the amount of PLT microbubbles attached to the endothelium, reflecting early structural changes in kidney injury. [16,27] Apart from the use of common contrast-enhanced ultrasonography to determine blood flow perfusion, [28,29] ultrasound-targeted microbubble destruction method has been improved for accurate evaluation in the present study. Rats with sepsis AKI were injected with Pla-MBs at various time points.…”

Transcription factor nuclear factor erythroid 2 p45-related factor 2 (NRF2) ameliorates sepsis-associated acute kidney injury by maintaining mitochondrial homeostasis and improving the mitochondrial function

“…NRK-52E cells derived from renal tubular duct epithelium of Rattus norvegicus (normal proximal tubule epithelial cells with epithelial-like morphology) were cultured in Dulbecco’s modified Eagle’s medium (11995065, Gibco, Thermo Fisher Scientific, Inc., Waltham, MA, USA) containing 10% fetal bovine serum (10270106, Gibco) and 1% penicillin/streptomycin at 37°C in a cell culture incubator with 5% CO 2 . A recombinant lentivirus carrying an expression construct gene NRF2 (LV-NRF2) and a recombinant lentivirus carrying a negative control (LV-NC) were generated by iGene Biotechnology (Guangzhou, China).…”

“… 1 Sepsis is the leading cause of AKI, and accounts for approximately 50% of AKI cases among Intensive Care Unit (ICU) patients. 2 , 3 Sepsis-associated acute kidney injury (S-AKI) has a mortality rate approaching 60%. 4 , 5 Under normal physiological conditions, tubular cells consume a large amount of energy to maintain normal function and survival, and this requires a large number of mitochondria to produce adenosine triphosphate (ATP).…”