{ "abstract": "Background: Acute kidney injury (AKI) is a common and serious complication of sepsis, significantly increasing both mortality risk and healthcare costs. Early prediction and diagnosis of sepsis-associated AKI (SA-AKI) remain challenging due to the delayed detection of existing renal injury markers. Although research suggests that the Renal Resistive Index (RRI) shows promise for earlier prediction of AKI, large-scale, multicenter clinical studies to support this are currently lacking. Methods: This multicenter, open-label, prospective observational cohort study enrolled 238 patients who were diagnosed with sepsis according to the Sepsis 3.0 criteria. The Renal Resistive Index (RRI) was measured using bedside ultrasound within 2 hours of diagnosis and subsequently every 8 hours during their individualized standard treatment. Concurrently, blood samples were collected to quantify creatinine and cystatin C, and urine samples were obtained to detect kidney injury markers, including TIMP-2/IGFBP-7. The primary endpoint is to determine the threshold and accuracy of the Renal Resistive Index in predicting sepsis-associated acute kidney injury (SA-AKI). Secondary endpoints include examining the dynamic trend of the RRI, assessing the RRI's predictive value for 28-day mortality in sepsis, and evaluating the correlation between the RRI and creatinine, cystatin C, and urinary TIMP-2/IGFBP-7 levels. Discussion: This study assesses the accuracy and feasibility of using bedside ultrasonography to monitor the Renal Resistive Index (RRI) for the early detection of sepsis-associated acute kidney injury (SA-AKI). Early identification of SA-AKI is crucial for improving clinical outcomes in sepsis, making this approach highly relevant for timely intervention. Ethics and Dissemination: This study received ethical approval from the Ethics Committee of the initiator's institution. Study results will be initially reported to the collaborating investigators. Following review and consensus by the Trial Steering Committee, the research report will be drafted by the initiating investigator and disseminated through peer-reviewed publications and presentations at scientific conferences. Trial registration: Chinese Clinical Trial Registry (ChiCTR2400082420), Registered on March 28, 2024.", "abstract_shown": true, "affiliations": [ "The Department of Critical Care Medicine of the Second Affiliated Hospital of Kunming Medical University, Kumming, China.", "Department of Medical Intensive Care Unit, General Hospital of Southern Theater Command, Guangzhou, China.", "Department of Critical Care Medicine, Jiangmen Central Hospital of Guangdong Province, Jiangmen, China.", "Department of Infection and Critical Care Medicine, Shenzhen Second People's Hospital & First Affiliated Hospital of Shenzhen University, Shenzhen, China.", "The First School of Clinical Medicine, Southern Medical University, Guangzhou, China." ], "article_type": "Study Protocol", "arxiv": null, "author_total": 6, "authors": [ { "affs": [ 0 ], "name": "Zongfang Ren", "orcid": "0000-0002-7804-1510" }, { "affs": [ 1 ], "name": "Lingling Wang" }, { "affs": [ 0 ], "name": "Jinxi Yue" }, { "affs": [ 2 ], "name": "Nimei Xu" }, { "affs": [ 3 ], "name": "Ming Wu" }, { "affs": [ 4, 1 ], "name": "Zhifeng Liu", "orcid": "0000-0001-6273-1667" } ], "bibtex": "https://research.draconitic.com/paper/1qwp0qrvm13rx.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0359982", "fulltext_url": "https://europepmc.org/articles/PMC13718935", "id": "1qwp0qrvm13rx", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0359982", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Anatomy" ], [ "heading", "Biochemistry" ], [ "heading", "Biology and Life Sciences" ], [ "heading", "Biomarkers" ], [ "heading", "Blood Pressure" ], [ "heading", "Body Fluids" ], [ "heading", "Clinical Medicine" ], [ "heading", "Creatinine" ], [ "heading", "Diagnostic Medicine" ], [ "heading", "Diagnostic Radiology" ], [ "heading", "Health Care" ], [ "heading", "Health Care Facilities" ], [ "heading", "Hematology" ], [ "heading", "Hemodynamics" ], [ "heading", "Hospitals" ], [ "heading", "Imaging Techniques" ], [ "heading", "Intensive Care Units" ], [ "heading", "Kidneys" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Physiology" ], [ "heading", "Radiology and Imaging" ], [ "heading", "Renal System" ], [ "heading", "Research and Analysis Methods" ], [ "heading", "Sepsis" ], [ "heading", "Signs and Symptoms" ], [ "heading", "Study Protocol" ], [ "heading", "Ultrasound Imaging" ], [ "heading", "Urine" ], [ "heading", "Vascular Medicine" ], [ "plos", "/Biology and life sciences/Anatomy/Body fluids/Urine" ], [ "plos", "/Biology and life sciences/Anatomy/Renal system/Kidneys" ], [ "plos", "/Biology and life sciences/Biochemistry/Biomarkers/Creatinine" ], [ "plos", "/Biology and life sciences/Physiology/Body fluids/Urine" ], [ "plos", "/Medicine and health sciences/Anatomy/Body fluids/Urine" ], [ "plos", "/Medicine and health sciences/Anatomy/Renal system/Kidneys" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Sepsis" ], [ "plos", "/Medicine and health sciences/Diagnostic medicine/Diagnostic radiology/Ultrasound imaging" ], [ "plos", "/Medicine and health sciences/Health care/Health care facilities/Hospitals/Intensive care units" ], [ "plos", "/Medicine and health sciences/Hematology/Hemodynamics" ], [ "plos", "/Medicine and health sciences/Radiology and imaging/Diagnostic radiology/Ultrasound imaging" ], [ "plos", "/Medicine and health sciences/Vascular medicine/Blood pressure" ], [ "plos", "/Research and analysis methods/Imaging techniques/Diagnostic radiology/Ultrasound imaging" ] ], "openalex": null, "pdf_url": "https://europepmc.org/articles/PMC13718935?pdf=render", "pmcid": "PMC13718935", "pmid": "42955912", "published": "2026-10-29", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/1qwp0qrvm13rx.ris", "sources": [ { "first_seen": "2026-10-30T12:17:17Z", "native_id": "10.1371/journal.pone.0359982", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0359982" }, { "first_seen": "2026-11-01T00:20:36Z", "native_id": "MED:42955912", "source": "europepmc", "url": "https://europepmc.org/article/MED/42955912" }, { "first_seen": "2026-11-02T12:22:52Z", "native_id": "PMC13718935", "source": "pmc", "url": "https://doi.org/10.1371/journal.pone.0359982" } ], "subjects": [ { "field": "biochemistry", "origin": "heading:Biochemistry", "subfield": "general" }, { "field": "biology", "origin": "heading:Biology and Life Sciences", "subfield": "general" }, { "field": "medicine", "origin": "plos:diagnostic radiology", "subfield": "imaging" }, { "field": "medicine", "origin": "plos:anatomy", "subfield": "physiology" } ], "title": "Dynamic assessment of renal resistive index using point-of-care ultrasonography for early detection of sepsis-induced acute kidney injury: A multicenter clinical trial protocol", "title_text": "Dynamic assessment of renal resistive index using point-of-care ultrasonography for early detection of sepsis-induced acute kidney injury: A multicenter clinical trial protocol", "type": "peer-reviewed", "updated_at": "2026-11-02T12:22:52Z", "url": "https://research.draconitic.com/paper/1qwp0qrvm13rx", "venue": "PLOS One", "versions": [] }