Advanced Ultrasound in Diagnosis and Therapy ›› 2021, Vol. 5 ›› Issue (3): 183-196.doi: 10.37015/AUDT.2021.210013

• Review Articles • Previous Articles     Next Articles

Doppler-based Renal Resistive Index for Prediction of Acute Kidney Injury in Critically Ill Patients: A Systematic Review and Meta-analysis

Jianing Zhu, MDa,c, Ying Zhang, MDa, Xiaoming Li, MDb,c, Qiuyang Li, MD, PHDa,*(), Yukun Luo, MD, PHDa,*()   

  1. aDepartment of Ultrasound, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
    bDepartment of Critical Care Medicine, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
    cMedical School of Chinese PLA, Beijing, China
  • Received:2021-05-23 Revised:2021-07-28 Online:2021-09-30 Published:2021-08-31
  • Contact: Qiuyang Li, MD, PHD,Yukun Luo, MD, PHD,;


Objectives: To determine the efficacy of Doppler-based renal resistive index (RRI) in the prediction of acute kidney injury (AKI) in critically ill patients.
Methods: A systematic review and meta-analysis of cohort studies was conducted. Relevant studies were identified in PubMed, Embase and Cochrane Library from inception to November 1, 2020, and reference lists of identified primary studies. Prospective studies that examined the diagnostic accuracy of RRI in AKI were included.
Results: Among the 126 articles identified, 18 were included, with a total of 1656 patients. Bivariate analysis yielded pooled sensitivity and specificity of 0.81 (95% CI 0.74-0.86) and 0.75 (95% CI 0.65-0.83), respectively. The summary positive likelihood ratio was 3.2 (95% CI 2.2-4.6), and negative likelihood ratio was 0.26 (95% CI 0.19-0.36).
Conclusion: Elevated RRI may be an early predictor of AKI in critically ill patients. Further large-scale prospective studies are needed to confirm the predictive efficacy and determine the performance and optimal cutoff value of RRI among the included studies.

Key words: Acute kidney injury; Renal resistive index; Critically ill patients; Systematic review; Meta-analysis