VExUS Score and AKI in Critically Ill Adult patients-a Prospective Observational Study.

NCT ID: NCT06889116

Last Updated: 2025-03-21

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 52 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2023-05-15
• Study Completion Date: 2024-01-11

Brief Summary

Introduction Renal perfusion is dependent on the renal perfusion pressure across the renal capillaries. Venous congestion due to excess fluid therapy can drastically reduce the renal perfusion pressure in spite of a normal mean arterial pressure. Increasing cumulative fluid balance during the ICU stay has been found to be associated with negative outcomes including acute kidney injury (AKI) and hospital mortality. Venous excess ultrasound (VExUS) to assess the Doppler studies of renal, hepatic and portal veins along with the inferior venacava has been shown to reliably predict the incidence of AKI in certain ICU patient population more specifically in cardiorenal syndrome. The aim of this study was to correlate the incidence of AKI and VExUS scores in a mixed ICU population and hence determine the contribution of venous congestion on the causation of AKI in a general ICU.

Methods:

The patients included who have AKI at admission or developed AKI during their ICU stay were included. The definition of AKI used for this study was as defined by Kidney Disease: Improving Global Outcomes (KDIGO). Point of care VExUS scans were done on each patient at inclusion (day 0), then each day for a total of 4 days (day 1, 2 and 3), till initiation of renal replacement therapy, death or discharge form the ICU. Correlation between VExUS grades and creatinine clearances was explored as the primary objective.

Conditions

Acute Kidney Injury; VExUS

Study Design

• Observational Model Type: CASE_ONLY
• Study Time Perspective: PROSPECTIVE

Study Groups

Patients with AKI

Patients who are admitted with the diagnosis of AKI or develop AKI during their ICU stay

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• Age ≥18 years
• Admitted to the adult ICUs of TUTH (ICU A and ICU B)
• Admitting diagnosis of AKI or who developed AKI during their ICU stay

Exclusion Criteria

• Pregnancy
• Diagnosed case of chronic kidney disease
• Diagnosed case of cirrhosis/ portal hypertension
• Arrhythmias which would interfere with the acquisition and interpretation of the Doppler waveforms
• Inferior venacava thrombus
• Poor window for assessment

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Tribhuvan University Teaching Hospital, Institute Of Medicine.

OTHER

Sponsor Role: lead

Responsible Party

Bipin Karki

Principle investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Tribhuvan University Teaching Hospital

Mahārājgañj, Bagmati, Nepal

Countries

Nepal

Other Identifiers

438(6-11)E2- 079/080

Identifier Type: -

Identifier Source: org_study_id