Abstract: Objective  To explore the predictive value of adhesion factors and renal resistance index(RRI) for early renal function recovery of patients with sepsis-associated acute kidney injury(AKI). 

Methods  Patients with sepsis-associated AKI treated in the Third Hospital of Hebei Medical University were enrolled as research subjects. General information of patients was collected. The patient's RRI was detected by bedside ultrasound, and plasma E-selectin, L-selectin and P-selectin as well as the levels of endothelial cell adhesion molecule-1(ICAM-1) and vascular cell adhesion molecule-1(VCAM-1) were measured by enzyme-linked immunosorbent assay(ELISA). They were followed up for 1 month. With renal function recovery at 30 d after enrollment as the standard, the subjects were divided into the renal function recovery group and the non-renal function recovery group. Logistic regression analysis method and receiver operating characteristic(ROC) curve were used to analyze the predictive value of RRI, adhesion factor, RRI combined with adhesion factor in the recovery of renal function in patients with sepsis-associated AKI. 
Results  A total of sepsis-associated AKI 78 patients, including 54 males and 24 females with a mean age of(70.8±23.3) years, were enrolled in this study. The expression of VCAM-1 in patients with sepsis-associated AKI was lower in the early renal function recovery group than in the non-renal function recovery group(P=0.0355). The APACHEⅡ score and white blood cell count of the early renal function recovery group were significantly lower than those of the non-renal function recovery group(P＜0.05). According to ROC analysis, the sensitivity and specificity of VCAM-1 combined with RRI in predicting early renal function recovery were 90.9％ and 32.1% respectively, with AUC=0.68． 
Conclusion  Combination of RRI and VCAM-1 has a high predictive value for early renal function recovery of patients with sepsis-associated AKI. The threshold of RRI is 0.71, and the threshold of VCAM-1 is 1 233 ng/L, which can be used as a predictor of early renal function recovery in patients with sepsis-associated AKI. 

Key words: acute kidney injury, sepsis, vascular cell adhesion molecule-1