الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 90 |  |  |
| | | from | 90 | | |
Abstract
The aim of the study is to investigate effect of Atorvastatin in Renal Protection for patients with systemic inflammatory response syndrome using renal arterial resistive index.
Patients were randomly allocated into to equal groups (each of 53): group I who received atorvastatin 20 mg/12 hour for a week plus conventional therapy (anti-microbial, balanced crystalloids) and group II (Control) who received conventional therapy only (anti-microbial, balanced crystalloids).
The following variables were assessed included Hemodynamics; heart rate (HR) blood pressure (BP), Renal resistive indices including Renal Resistive Index, Pulsatility Index and Mean Flow Velocity were recorded at admission, 6hours, 24 hours and 72 hours after admission, Incidence of Acute Kidney Injury, SOFA score APACHE II score, Laboratory data (total leucocytic count, urea, serum creatinine and urine output) and Length of stay in ICU.
The hemodynamic variables and laboratory data were comparable between the two studied groups.
Renal arterial resistive index and pulsatility index were significantly lower in patients received atorvastatin when compared to control group, while there was no statically significant difference among the studied groups regarding mean flow velocity.
The incidence of AKI was significantly higher in control group (32.1%) versus atorvastatin group (5.7%). The length of stay in ICU was significantly prolonged in control group when compared to patients who received atorvastatin. One Patient died in control group due to multiple organ failure.
SOFA score was statically significantly lower in patients received Atorvastatin compared to Control group at the studying period.
Analysis of ROC curve For RRI, the optimal cut off value was > 0.61, positive predictive value was 90% and negative predictive value was 59%. Also for PI, the optimal cut off value was >1.28, positive predictive value was 90% and negative predictive value was 46.5%. And for APACHE II score, the optimal cut off value was off value >6, positive predictive value was 85% and negative predictive value was 64%.
Conclusion
We conclude that, administration of oral Atorvastatin in a dose 20 mg every 12 hrs. for one week reduces renal resistive index and pulsatility index ,and decreases the incidence of AKI and ICU stay in patients with systemic inflammatory response syndrome.
Pulsatility index and renal arterial resistive index are significant predictors for AKI. Results established the superiority of RI over PI for prediction of acute kidney injury.
Recommendations
- Based on our results, we recommend oral administration of Atorvastatin in renal protection for patients with systemic inflammatory response syndrome.
- We recommend use of renal arterial resistive index and pulsatility index
as an early predictors of Acute Kidney Injury.
-Further Studies with a large sample size are recommended to confirm our results.