Doppler-based evaluation of intrarenal venous flow as a new tool to predict acute kidney injury: A systematic review and meta-analysis

array:23 ["pii" => "S2013251423000858" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2023.05.010" "estado" => "S300" "fechaPublicacion" => "2023-12-01" "aid" => "1153" "copyright" => "Sociedad Española de Nefrología" "copyrightAnyo" => "2023" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2023;43 Supl 2:57-66" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S2013251424000294" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2024.01.019" "estado" => "S300" "fechaPublicacion" => "2023-12-01" "aid" => "1158" "copyright" => "Sociedad Española de Nefrología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2023;43 Supl 2:67-76" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Short Original" "titulo" => "Relationship between biochemical parameters of mineral bone disease and static bone histomorphometry in chronic kidney disease patients on hemodialysis: An Indian cross-section study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "67" "paginaFinal" => "76" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2901 "Ancho" => 2500 "Tamanyo" => 209368 ] ] "descripcion" => array:1 [ "en" => "Boxplot showing the impact of age on osteoblast surface (p=0.008) and eroded surface (p=0.031)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Manish Chaturvedy, Santosh Kumar Maurya, Nitin Kumar Bajpai, Mahendra Kumar Jangid, Poonam Elhence, Abhay Elhence, Akhil Dhanesh Goel, Praveen Sharma, Prem Prakash Sharma, Rajesh Jhorawat" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Manish" "apellidos" => "Chaturvedy" ] 1 => array:2 [ "nombre" => "Santosh Kumar" "apellidos" => "Maurya" ] 2 => array:2 [ "nombre" => "Nitin Kumar" "apellidos" => "Bajpai" ] 3 => array:2 [ "nombre" => "Mahendra Kumar" "apellidos" => "Jangid" ] 4 => array:2 [ "nombre" => "Poonam" "apellidos" => "Elhence" ] 5 => array:2 [ "nombre" => "Abhay" "apellidos" => "Elhence" ] 6 => array:2 [ "nombre" => "Akhil Dhanesh" "apellidos" => "Goel" ] 7 => array:2 [ "nombre" => "Praveen" "apellidos" => "Sharma" ] 8 => array:2 [ "nombre" => "Prem Prakash" "apellidos" => "Sharma" ] 9 => array:2 [ "nombre" => "Rajesh" "apellidos" => "Jhorawat" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251424000294?idApp=UINPBA000064" "url" => "/20132514/00000043000000S2/v2_202402210544/S2013251424000294/v2_202402210544/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2013251423000846" "issn" => "20132514" "doi" => "10.1016/j.nefroe.2023.05.009" "estado" => "S300" "fechaPublicacion" => "2023-12-01" "aid" => "1150" "copyright" => "Sociedad Española de Nefrología" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Nefrologia (English Version). 2023;43 Supl 2:47-56" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Serum chloride as a marker of cardiovascular and all-cause mortality in chronic hemodialysis patients: 5-Year follow-up study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "47" "paginaFinal" => "56" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0035" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2512 "Ancho" => 2508 "Tamanyo" => 352112 ] ] "descripcion" => array:1 [ "en" => "Kaplan–Meier estimates of cumulative all-cause survival rates. Patients were stratified into four groups according to median CRP and Cl−." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Valga, Tania Monzon, Nicanor Vega-Diaz, Angelo Santana, Giancarlo Moscol, Sergio Ruiz-Santana, Jose Carlos Rodriguez-Perez" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Francisco" "apellidos" => "Valga" ] 1 => array:2 [ "nombre" => "Tania" "apellidos" => "Monzon" ] 2 => array:2 [ "nombre" => "Nicanor" "apellidos" => "Vega-Diaz" ] 3 => array:2 [ "nombre" => "Angelo" "apellidos" => "Santana" ] 4 => array:2 [ "nombre" => "Giancarlo" "apellidos" => "Moscol" ] 5 => array:2 [ "nombre" => "Sergio" "apellidos" => "Ruiz-Santana" ] 6 => array:2 [ "nombre" => "Jose Carlos" "apellidos" => "Rodriguez-Perez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251423000846?idApp=UINPBA000064" "url" => "/20132514/00000043000000S2/v2_202402210544/S2013251423000846/v2_202402210544/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Doppler-based evaluation of intrarenal venous flow as a new tool to predict acute kidney injury: A systematic review and meta-analysis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "57" "paginaFinal" => "66" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Nicholas S.M. Bianchi Bosisio, Gregorio Romero-González, Annalisa De Silvestri, Faeq Husain-Syad, Fiorenza Ferrari" "autores" => array:5 [ 0 => array:3 [ "nombre" => "Nicholas S.M." "apellidos" => "Bianchi Bosisio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Gregorio" "apellidos" => "Romero-González" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Annalisa" "apellidos" => "De Silvestri" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 3 => array:3 [ "nombre" => "Faeq" "apellidos" => "Husain-Syad" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 4 => array:4 [ "nombre" => "Fiorenza" "apellidos" => "Ferrari" "email" => array:1 [ 0 => "fioreferrari28@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, Italy" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Nephrology, Hospital Germans Trias i Pujol, Badalona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Clinical Epidemiology and Biometrics Service, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Anaesthesiology and Intensive Care Unit 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy" "etiqueta" => "f" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación del flujo venoso intrarrenal mediante Doppler como una nueva herramienta para predecir la lesión renal aguda: revisión sistemática y metaanálisis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1875 "Ancho" => 2917 "Tamanyo" => 156409 ] ] "descripcion" => array:1 [ "en" => "Forest plot of comparison." ] ] ] "textoCompleto" => "IntroductionThe occurrence of acute kidney injury (AKI) in patients admitted to the intensive care unit (ICU) varies between 30% and 60%.<a class="elsevierStyleCrossRefs" href="#bib0200">1,2</a> AKI is defined as a decrease in kidney function based on elevated serum creatinine (SCr) levels, a decrease in urinary output, or the need for renal replacement therapy.<a class="elsevierStyleCrossRef" href="#bib0210">3</a> Different pathophysiological pathways can lead to the development of AKI in critically ill patients.<a class="elsevierStyleCrossRef" href="#bib0215">4</a> Renal hypo-perfusion has long been considered as one of the main predisposing factors for AKI in critically ill patients.<a class="elsevierStyleCrossRef" href="#bib0220">5</a> However, already in 1931,<a class="elsevierStyleCrossRef" href="#bib0225">6</a> the role of venous congestion in worsening renal function came to light, and this historical study demonstrated that glomerular intra-capillary pressure is about two-thirds the renal artery pressure. Reduction in glomerular intra-capillary pressure results in a decrease in renal perfusion pressure and consequent diminution of the glomerular filtrate rate (GFR).<a class="elsevierStyleCrossRef" href="#bib0230">7</a> On the other hand, the effect of increased central venous pressure transmitted through low-resistance renal vessels in encapsulated organs, such as the kidneys, increases renal afterload and intrarenal pressure, driving renal dysfunction and resulting in a condition known as congestive nephropathy, which was recently described as a mechanism of AKI.<a class="elsevierStyleCrossRef" href="#bib0235">8</a> The increase in pressure decreases renal perfusion and intratubular flow, leading to a decrease in GFR, an increase in sodium and water retention mediated by activation of the renin-angiotensin aldosterone system, and tubular damage mediated by the activation of inflammatory mechanisms.<a class="elsevierStyleCrossRef" href="#bib0240">9</a>In the ICU setting, many factors could lead to venous congestion, such as fluid overload,<a class="elsevierStyleCrossRefs" href="#bib0240">9-11</a> positive pressure mechanical ventilation,<a class="elsevierStyleCrossRef" href="#bib0255">12</a> right ventricular failure and pulmonary hypertension.<a class="elsevierStyleCrossRef" href="#bib0260">13</a> However, there is no validated diagnostic test to assess whether venous congestion and/or fluid overload play a direct role in impairing renal perfusion. Recently, Doppler-based evaluation of intrarenal vessels has been used for assessing renal haemodynamics. With Doppler imaging, increase in renal venous congestion can be detected through the analysis of renal venous waveforms. Discontinuous intrarenal venous flow (IRVF) patterns suggest an increase in compliance of the renal parenchyma and its venous vessels secondary to increase in venous pressure within the encapsulated kidney.<a class="elsevierStyleCrossRefs" href="#bib0260">13–18</a> Doppler-based ultrasonography could have high clinical feasibility and acceptable reproducibility for the evaluation of IRVF in a non-invasive way.<a class="elsevierStyleCrossRefs" href="#bib0290">19,20</a> Therefore, the main objective of this systematic review and meta-analysis is to assess the ability of renal pulsed Doppler (RPD) evaluation of IRVF to predict the development of AKI in critically ill patients.MethodsSearch strategy and eligibility assessmentThe present systematic review and meta-analysis were performed according to the general principles of the MOOSE statement<a class="elsevierStyleCrossRefs" href="#bib0300">21,22</a> (<a class="elsevierStyleCrossRef" href="#sec0095">Supplementary Information 2).</a>We reviewed public-domain databases including Pubmed-MEDLINE, Scopus, Embase and the Cochrane Library. For the search, medical subject heading (MeSH) terms and text words were used with the Boolean strategy, and cross-searches were performed with the following three categories: (1) disease (“acute kidney injury” OR “kidney injury” OR “acute renal injury” OR “renal injury” OR “renal failure” OR “acute renal failure” OR “acute kidney failure” OR “kidney failure” OR “acute renal damage” OR “renal damage” OR “acute kidney damage” OR “kidney damage”) AND (2) tools (“renal Doppler” OR “renal vascular Doppler” OR “intrarenal Doppler” OR “intrarenal venous Doppler” OR “intrarenal vascular Doppler” OR “intrarenal arterial Doppler” OR “renal arterial Doppler” OR “renal venous Doppler” OR “renal ultrasound” OR “renal echography” OR “kidney ultrasound” OR “kidney echography” OR “kidney Doppler” OR “kidney vascular Doppler” OR “kidney arterial Doppler” OR “kidney venous Doppler” OR “renal resistive index” OR “renal venous flow” OR “Intrarenal venous flow”) AND (3) setting (“intensive care unit” OR “critical care” OR “critically ill patients” OR “critically ill patient” OR “critical illness” OR “critically ill” OR “critical care unit” OR “intensive care”). The search was restricted to articles published in English and studies on humans published between the 1st of January 2000 and the 31st of December 2021. We considered as type of study for inclusion, the randomised trial and the observational studies.All references were downloaded for consolidation, elimination of duplicates and further analysis. Three authors, two intensivist and one nephrologist, (NSMBB, GRG and FF) independently determined the eligibility of all the studies identified in the initial research.Data extractionTwo authors (NSMBB and GRG) carried out data extraction independently. Disagreements between the two were resolved by a third investigator (FF).We framed the search around a PICOS (participants, intervention, comparison, outcomes, study design) model to determine the eligibility criteria of the studies to be included in this systematic review. The participants of interest were critically ill adult patients >18 years old admitted to any kind of ICU. Patients with end-stage chronic kidney disease and those who had undergone renal transplant were excluded. “Intervention” was considered as the execution of the RPD with the venous pattern at the time of ICU admission, and the comparison was IRVF pattern related to AKI occurrence.The outcome of interest was the association between Doppler-based intrarenal venous flow demodulation (any IRVF pattern that is not continuous) and AKI. We included studies that diagnosed AKI based on the AKIN,<a class="elsevierStyleCrossRef" href="#bib0310">23</a> RIFLE<a class="elsevierStyleCrossRef" href="#bib0315">24</a> diagnosed AKI based and KDIGO<a class="elsevierStyleCrossRef" href="#bib0210">3</a> criteria.The study design included prospective and retrospective observational studies and randomised clinical trials.Statistical analysisWe conducted all the analyses using the statistical package STATA 13. We statistically analysed the dichotomous outcomes using risk ratios (RRs) as the summary statistic. Data were pooled only for studies that reported sufficiently similar clinical and methodological variables. A pooled estimate of the RR was computed using the DerSimonian and Laird random-effects model.<a class="elsevierStyleCrossRef" href="#bib0320">25</a> This calculation provides an appropriate estimate of the average treatment effect when studies are statistically heterogeneous. Heterogeneity among the studies was assessed by the I2 test and a null hypothesis test, in which p<0.1 was considered to indicate significant outcome heterogeneity.ResultsThe literature search yielded 1143 potentially relevant articles, of which 182 were excluded because they were duplicates. Among the 961 remaining articles, 848 were excluded because they were irrelevant based on the scope of this review (45 were not published in English; 450 were abstracts, letters, conference articles, reviews, or meta-analyses; 48 were conducted on non-human subjects; 51 included children; and 254 included non-critically ill patients).The full texts of the remaining 113 articles were reviewed independently by two investigators (NSMBB and GRG) for further evaluation. Of these 113 articles, 109 were excluded because they did not include Doppler-based intrarenal venous flow evaluation (58 did not include any kind of RPD measurements, and 51 reported only arterial RPD measurements). Finally, four studies<a class="elsevierStyleCrossRefs" href="#bib0315">24–27</a> fulfilled our eligibility criteria and were included (<a class="elsevierStyleCrossRef" href="#fig1">Fig. 1</a> and <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="fig1"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Characteristics of the included studies and participantsThe included studies were conducted between 2016 and 2020 and enrolled a total of 660 patients. All of them were single-centre prospective cohort studies (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).Two of the studies were conducted in Europe and included a total of 401 (60.75%) patients (of whom 371 were part of a Netherlands study<a class="elsevierStyleCrossRef" href="#bib0330">27</a> and 30 were part of an Italian study<a class="elsevierStyleCrossRef" href="#bib0325">26</a>), and two were conducted in North America on a total of 259 (39.25%) patients (145 were recruited in a USA study<a class="elsevierStyleCrossRef" href="#bib0340">29</a> and 114 were recruited in a Canadian study<a class="elsevierStyleCrossRef" href="#bib0335">28</a>). Of the 660 participants, 444 (67.27%) were males with an age range of 57–66 years (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). The race of the participants was only specified by Spiegel et al.<a class="elsevierStyleCrossRef" href="#bib0340">29</a>: 58 (50.90%) were Caucasians, 49 (42.90%) were Africans and 2 (1.8%) were Asians. The reported diagnosis of the patients varied across studies: 275 (41.67%) were scheduled for surgery<a class="elsevierStyleCrossRefs" href="#bib0320">25,26</a> (of whom 145 underwent elective cardiac surgery<a class="elsevierStyleCrossRef" href="#bib0335">28</a>), 26 (3.94%) had septic shock<a class="elsevierStyleCrossRefs" href="#bib0315">24–27</a> and 26 (3.94%) had non-categorised Adults Respiratory Distress Syndrome (ARDS).<a class="elsevierStyleCrossRef" href="#bib0325">26</a> However, the diagnosis at admission was not defined clearly in 241 cases (36.52%),<a class="elsevierStyleCrossRef" href="#bib0330">27</a> and a diagnosis was lacking at the time of admission in 92 (13.94%) patients.<a class="elsevierStyleCrossRef" href="#bib0340">29</a> The most recent study included 15 (2.27%) COVID-19 patients.<a class="elsevierStyleCrossRef" href="#bib0325">26</a> Three of the selected studies<a class="elsevierStyleCrossRefs" href="#bib0315">24,25,27</a> were performed in a multidisciplinary ICU (these three studies included 515 patients or 78.03% of the total participants included in this review), while the fourth one<a class="elsevierStyleCrossRef" href="#bib0335">28</a> was conducted in a specific post-cardiac surgery ICU (this study included 145 patients or 21.97% of the total participants). Severity score was determined in two studies<a class="elsevierStyleCrossRefs" href="#bib0315">24,27</a>; both studies reported the SOFA score to range from 7 to 8 (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Study quality assessmentThe quality of studies was assessed using the risk-of-bias method recommended by the Newcastle–Ottawa quality assessment scale for cohort studies.<a class="elsevierStyleCrossRef" href="#bib0345">30</a> FF, NSMBB and GRG individually assessed the scores, which are presented in <a class="elsevierStyleCrossRef" href="#sec0095">Supplementary Information 1</a>.Definition of renal function and AKIFogagnolo et al.<a class="elsevierStyleCrossRef" href="#bib0325">26</a> defined renal function based on SCr level, and Beaubien-Souligny et al.<a class="elsevierStyleCrossRef" href="#bib0335">28</a> defined renal function based on eGFR with the MDRD formula.<a class="elsevierStyleCrossRef" href="#bib0350">31</a> However, renal function was not defined in the other two studies<a class="elsevierStyleCrossRefs" href="#bib0320">25,27</a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).Three studies<a class="elsevierStyleCrossRefs" href="#bib0315">24–26</a> defined AKI according to the KDIGO guidelines,<a class="elsevierStyleCrossRef" href="#bib0210">3</a> without introducing any definition of the baseline SCr level. Spiegel et al.<a class="elsevierStyleCrossRef" href="#bib0340">29</a> adopted major adverse kidney event (MAKE-30)<a class="elsevierStyleCrossRef" href="#bib0355">32</a> as the primary outcome (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).Renal pulsed Doppler examination imaging quality, investigator, and timingAlthough assessment of both kidneys is preferable, the right kidney is generally more accessible. Therefore, all selected studies have limited the investigation to this side. The RPD examination was performed by investigators trained in RPD,<a class="elsevierStyleCrossRefs" href="#bib0320">25–27</a> under the supervision of a radiologist,<a class="elsevierStyleCrossRefs" href="#bib0320">25,26</a> a single well-trained anaesthesiologist with certified experience in examination of the right kidney,<a class="elsevierStyleCrossRef" href="#bib0325">26</a> or a critical care fellow with 1-month clinical training in POCUS and transthoracic echocardiography. The inter-rater reliability between examiners or supervisors was evaluated only in two studies,<a class="elsevierStyleCrossRefs" href="#bib0325">26,27</a> and the method used was described in only one of these studies.<a class="elsevierStyleCrossRef" href="#bib0335">28</a> In two studies,<a class="elsevierStyleCrossRefs" href="#bib0320">25,26</a> the investigators were blinded to the clinical and laboratory data. In the Spiegel et al. study, the images, interpretations and recommendations for care were not discussed with or made available to the treating clinicians, and Doppler waveforms were reviewed by two members of the research team who were blinded to the clinical outcomes.<a class="elsevierStyleCrossRef" href="#bib0340">29</a> In one study,<a class="elsevierStyleCrossRef" href="#bib0330">27</a> it was not disclosed whether the examiner was blinded to the patient data. Three studies<a class="elsevierStyleCrossRefs" href="#bib0320">25–27</a> reported that the venous renal RPD signal was inadequate. This meant that 162 (24.54%) of the patients did not have an IRVF evaluation (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Wieserma et al.<a class="elsevierStyleCrossRef" href="#bib0325">26</a> performed RPD upon inclusion (mean time to inclusion was 13±7h); Spiegel et al.<a class="elsevierStyleCrossRef" href="#bib0335">28</a> and Fogagnolo et al.<a class="elsevierStyleCrossRef" href="#bib0320">25</a> within 24h from ICU admission and from the invasive mechanical ventilation start, respectively. Souligny et al. planned a preoperative ultrasound assessment<a class="elsevierStyleCrossRef" href="#bib0330">27</a> and only they repeated the exam at Day #1, #2, #3 after the surgery.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>AKI occurrence and Doppler-based evaluation of IRVF for the prediction of AKIAKI occurrence ranged between 34% and 68%. Severe AKI (KDIGO stage 2 and 3) occurrence was only found in two studies<a class="elsevierStyleCrossRefs" href="#bib0320">25,26</a>: it was reported in 58%<a class="elsevierStyleCrossRef" href="#bib0330">27</a> and 7%<a class="elsevierStyleCrossRef" href="#bib0335">28</a> of the AKI patients (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). Beaubien-Souligny demonstrated an association between monophasic venous flow and any AKI stage (HR=2.81; 95% CI 1.42–5.56; p=0.003). Fogagnolo et al.<a class="elsevierStyleCrossRef" href="#bib0320">25</a> described a higher percentage of an impaired IRVF (13/13 in AKI group vs 1/17 in no AKI group; p<0.001) in the patients who developed AKI. On the other hand, Spiegel et al.<a class="elsevierStyleCrossRef" href="#bib0335">28</a> demonstrated that the biphasic or monophasic patterns were not associated with an increase in the rate of MAKE-30 events in their cohort, as well as no difference was observed in IRVF patterns between patients with and without AKI by Wiersema et al.<a class="elsevierStyleCrossRef" href="#bib0325">26</a>No study analysed the association between the IRVF patterns and the ethiology of AKI or with the renal recovery.All the studies we reviewed had investigated the RPD venous pattern. We used data obtained from three<a class="elsevierStyleCrossRefs" href="#bib0325">26–28</a> of these in our metanalysis (in total 413 patients, because an inadequate venous RPD sign was found in 113 patients. One study<a class="elsevierStyleCrossRef" href="#bib0340">29</a> was excluded because its data were inadequate for pooling. We found a significant difference between patients who had RPD continuous flow and demodulated IRVF (RR=0.46; 95% CI=0.28–0.76; <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Further, our results revealed significant heterogeneity across the studies (I2=68.7%; 95% CI 0–90, p=0.04).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>DiscussionAdequate preventive and curative strategies for AKI are still lacking. Indeed, SCr, the most widely used biomarker for diagnosing AKI that is available worldwide, has poor specificity, results in delayed diagnosis, and does not provide prompt detection of tubular injury. In addition, SCr kinetics and other factors (such as catabolism, fluid overload, nutrition and lean tissue status) can postpone or confound the diagnosis in critically ill patients.<a class="elsevierStyleCrossRef" href="#bib0210">3</a> Other diagnostic methods, such as detection of new biomarkers, have been studied with regard to their ability for prediction, timely diagnosis and risk stratification of AKI.<a class="elsevierStyleCrossRef" href="#bib0360">33</a> However, the diffusion of these diagnostic tools is still limited, and their cost cannot be borne in low- and middle-income countries. As a result of this situation, ultrasound scanning has become a reliable tool for clinicians in the emergency and critical care setting,<a class="elsevierStyleCrossRef" href="#bib0365">34</a> but in the ICU setting, RPD still has limited use compared with lung ultrasonography and echocardiography.Renal resistive index (RRI) and IRVF are the parameters used to assess renal perfusion and congestion. In the kidneys, which are capsulated organs, interstitial oedema resulting from renal insult translates into increased subcapsular pressure that ultimately causes a decrease in renal perfusion<a class="elsevierStyleCrossRef" href="#bib0370">35</a> and is likely to cause a decrease in renal vascular compliance while increasing RRI. Additionally, kidneys are also affected by increased intrabdominal pressure that could be related to abnormalities in the abdomen itself or transmission of raised airway pressure in a stiffened lung through the diaphragm.<a class="elsevierStyleCrossRefs" href="#bib0365">34,35</a> In such situations, IRVF could be beneficial as it can suggest increased pressure in a close compartment, such as Gerota's capsule. Waveforms detected by ultrasound can not only reflect kidney injury, but also indicate the severity of congestion. Therefore, waveforms have prognostic significance and can be used to monitor the efficacy of a therapy. Moreover, as point-of-care ultrasonography can be performed by experts at the patient's bedside, immediate clinical integration of the imaging data is possible.In the present systematic review and meta-analysis, we explored the ability of Doppler-based evaluation of IRVF demodulation in predicting the development of AKI in critically ill patients. Notably, our findings also provide several insights that go beyond the primary objective of the study.Our results indicated that patients with continuous IRVF had less than half the risk of developing AKI than patients with demodulated IRVF. All selected studies contributed to this result (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).However, despite the high quality of the included studies, our metanalysis showed a significant heterogeneity.This heterogeneity may be partially explained by the small number of studies included in the metanalysis.<a class="elsevierStyleCrossRef" href="#bib0385">36</a> On the other hand, based on the PICOS criteria, we identified adult critically ill patients, but we could not find a uniform target population. Many factors differentiate the population of the selected studies. The age of the population ranged from 57 to 66 years, and male sex was prevalent in all the studies. Severity scores were reported in only two studies, both of which exclusively calculated the SOFA scores,<a class="elsevierStyleCrossRefs" href="#bib0315">24,27</a> then we could not compare the severity of the illness of each study population. The diagnosis for which the patient was admitted to the ICU was not clearly defined in 241 cases (36.52%) and there was no diagnosis at admission in 92 (13.94%) patients. Furthermore, the multidisciplinary nature of some TI studies suggests a varied melting pot of diagnoses and degrees of severity.Bedsides, RPD examination was performed in critically ill patients with various diagnoses at the time of ICU admission and in only one study<a class="elsevierStyleCrossRef" href="#bib0335">28</a> RPD has been revaluated during ICU stay. Finally, AKI was defined based on the KDIGO guidelines in three of the studies, but only some of the data described renal function at the time of admission or baseline kidney function.RPD examination was performed by investigators trained under the supervision of a single well-trained anaesthesiologist with certified experience or a critical care fellow with 1-month clinical training in POCUS and transthoracic echocardiography. The inter-rater reliability between examinators or supervisors was evaluated in two studies, but the method used was described in only one. RPD examination could not be performed in 24.54% of the patients, but the authors did not clearly explain the reason why it could not be performed or the limits of its feasibility and reliability.However, the evaluation of RRI and IRVF is fast, non-invasive and repeatable, and can be performed in most patients by inexperienced operators after a half-day course.39 In critically ill patients, the interobserver reproducibility between a senior and inexperienced operator is good and the measures seem accurate (as indicated by the absence of systematic bias in the reviewed studies), although a lack of precision was found (based on an interobserver 95% confidence interval of ±0.1).<a class="elsevierStyleCrossRef" href="#bib0390">37</a>ConclusionsDespite its limitations, IRVF is useful for detecting venous congestion and congestive nephropathy, which are associated with impaired renal function. Although the preliminary results in this field are promising, nowadays controversial results have been published in this setting. The heterogeneity of our metanalyses demonstrates once again that confirmatory studies are still needed to assess the feasibility of using IRVF measured with RPD as a predictor of AKI in critically ill patients.Authors’ contributionsNSMBB conceived the study and participated in study design, acquisition of data, interpretation of data, drafting of the manuscript.GAR participated in acquisition of data and participated in critical revision of the manuscript.ADS performed the statistical analysis.FF participated in study concept, design and coordination, statistical analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript.FHS, participated in critical revision of the manuscript.FF, NSMBB had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.All authors read and approved the final manuscript.FundingNone declared.Conflict of interestThe authors have declared that no conflict of interest exists." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres2093832" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1784628" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres2093831" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1784627" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Search strategy and eligibility assessment" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Data extraction" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Characteristics of the included studies and participants" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Study quality assessment" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Definition of renal function and AKI" ] 3 => array:2 [ "identificador" => "sec0050" "titulo" => "Renal pulsed Doppler examination imaging quality, investigator, and timing" ] 4 => array:2 [ "identificador" => "sec0055" "titulo" => "AKI occurrence and Doppler-based evaluation of IRVF for the prediction of AKI" ] ] ] 7 => array:2 [ "identificador" => "sec0060" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0065" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0070" "titulo" => "Authors’ contributions" ] 10 => array:2 [ "identificador" => "sec0075" "titulo" => "Funding" ] 11 => array:2 [ "identificador" => "sec0080" "titulo" => "Conflict of interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-08-15" "fechaAceptado" => "2023-03-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1784628" "palabras" => array:6 [ 0 => "Renal ultrasound" 1 => "Renal venous pulsed Doppler" 2 => "VExUS" 3 => "Acute kidney injury" 4 => "Congestive nephropathy" 5 => "Intrarenal venous flow" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1784627" "palabras" => array:6 [ 0 => "Ecografía renal" 1 => "Doppler pulsado renal" 2 => "VExUS" 3 => "Lesión renal aguda" 4 => "Nefropatía congestiva" 5 => "Flujo venoso intrarrenal" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Congestion is a common complication in the critical care setting, these patients are at increased risk of developing acute kidney injury (AKI). Congestive nephropathy (CN) has recently been described as a mechanism of worsening renal function, and evaluation of renal venous flow by pulsed Doppler (PD) is a useful tool to assess the presence of renal vein congestion. We comprehensively explore the ability of the PD in the evaluation of the intrarenal venous flow (IRVF) to predict the development of AKI in critically ill patients.We searched Pubmed-MEDLINE, Scopus, Embase, and Cochrane Library of Systematic Reviews (to 31th December 2021). We evaluated the association between Doppler-based Intrarenal venous flow demodulation and AKI. CN was defined as the presence of a pulsatile pattern (biphasic or monophasic) in the PD.A total of 4 articles (660 patients) were included in our systematic review, three of these in the metanalysis (413 patients): one study was excluded because its data were inadequate for pooling. Two studies originated in Europe and the other two in the United States. AKI occurrence ranged between 34 and 68%. Patients who developed AKI had a significant difference in PD pattern (continuous vs. pulsatile) in the IRVF (RR=0.46; 95% CI 0.28–0.76). Nevertheless, a large heterogeneity was observed among the studies (I2=68.7%; p=0.04).Albeit preliminary, these findings suggest that the presence of a pulsatile pattern in the PD of the IRVF may be involved in the development of AKI in the critically ill patient. The effect of alterations in the IRVF and renal function warrant further investigation." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "La congestión es una complicación frecuente en el entorno de las unidades de cuidado crítico, y estos pacientes tienen un mayor riesgo de desarrollar una lesión renal aguda (LRA). La nefropatía congestiva (NC) se ha descrito recientemente como un mecanismo de deterioro de la función renal, y la evaluación del flujo venoso renal mediante Doppler pulsado (DP) es una herramienta útil para valorar la presencia de congestión venosa renal. Exploramos de forma exhaustiva la capacidad del DP en la evaluación del flujo venoso intrarrenal (FVIR) para predecir el desarrollo de LRA en pacientes en estado crítico.Se realizaron búsquedas en Pubmed-MEDLINE, Scopus, Embase y la Biblioteca Cochrane de Revisiones Sistemáticas (hasta el 31 de diciembre de 2021). Se evaluó la asociación entre la demodulación del flujo venoso intrarrenal basada en Doppler y la LRA. La NC se definió como la presencia de un patrón pulsátil (bifásico o monofásico) en el DP.Se incluyeron un total de 4 artículos (660 pacientes) en nuestra revisión sistemática, tres de ellos en el metaanálisis (413 pacientes): se excluyó un estudio porque sus datos eran inadecuados para el análisis. Dos estudios procedían de Europa y los otros dos de Estados Unidos. La aparición de LRA osciló entre el 34 y el 68%. Los pacientes que desarrollaron LRA presentaban una diferencia significativa en el patrón de DP (continua frente a pulsátil) en el FVIR (RR=0,46; IC del 95%: 0,28-0,76). No obstante, se observó una gran heterogeneidad entre los estudios (I2=68,7%; p=0,04).Aunque preliminares, estos hallazgos sugieren que la presencia de un patrón pulsátil en el DP del FVIR puede estar asociado al desarrollo de la LRA en el paciente crítico. El efecto de las alteraciones en el FVIR y la función renal obligan a desarrollar futuras investigaciones." ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0095" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2554 "Ancho" => 1675 "Tamanyo" => 199970 ] ] "descripcion" => array:1 [ "en" => "The MOOSE flow diagram of study selection. The flow diagram shows the flow of information through the different phases of the systematic review: the number of records identified, included and excluded, and the reasons for exclusions (see study selection paragraph for details)." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1875 "Ancho" => 2917 "Tamanyo" => 156409 ] ] "descripcion" => array:1 [ "en" => "Forest plot of comparison." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study country \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study period \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study design \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study population \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample size (n) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SCr dosing method \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">eGFR estimation \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary endpoint \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Secondary endpoint \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI definition \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fogagnolo A et al., 2021<a class="elsevierStyleCrossRef" href="#bib0325">26</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Italy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single-centre prospective observational cohort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Critically ill patients with SARS-COV-2 ARDS or other aetiology ARDS undergoing mechanical ventilation without AKI before ICU admission \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Assess if the degree of renal blood flow impairment in SARS-COV-2 ARDS compared to other aetiology ARDS could be more pronunced \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Investigate the ability of RRI to predict the occurrence of AKI and the need of RRT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">KDIGO criteria \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wiersema R et al., 2020<a class="elsevierStyleCrossRef" href="#bib0330">27</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Netherlands \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 May 2018–10 July 2019 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single-centre prospective observational cohort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Critically ill patients, above 18 years of age, acutely admitted, expected ICU stay at least 24h \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">371 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Assess the diagnostic accuracy of the RRI and VII for persistent AKI in a large heterogeneous cohort of critically ill patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">KDIGO criteria \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Beaubien-Souligny W et al., 2018<a class="elsevierStyleCrossRef" href="#bib0335">28</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Canada \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">August 2016–July 2017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single-centre prospective observational cohort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patients 18 years and older undergoing cardiac surgery with the use of cardiopulmonary bypass without severe CKD or renal transplantation, critical preoperative state and documented AKI or delirium before surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">145 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Enzymatic assay (IDMS-standardised) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MDRD formula \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Development of AKI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">KDIGO criteria \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spiegel R et al., 2020<a class="elsevierStyleCrossRef" href="#bib0340">29</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">USA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">January 2019–June 2019 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single-centre prospective observational cohort \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adult patients admitted to medica, surgical, trauma or neurotrauma ICUs. Patients with ESRD on outpatient hemodialysis, transplanted kidney or liver were ecluded \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">114 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Major adverse kidney event within 30 days (MAKE-30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MAKE-30 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3465237.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristics of the selected studies." ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Males(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age(mean±SD/median [25th–75th percentiles], years) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SAPSII(median [25th–75th percentiles]) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">APACHE(median [25th–75th percentiles]) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SOFA(median [25th–75th percentiles]) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ARDS (n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Septic shock(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cardiogenic shock(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Other shock(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-well defined medical admission(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cardiac surgery (n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fogagnolo A et al., 2021<a class="elsevierStyleCrossRef" href="#bib0325">26</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 [60–72] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 [5–10] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (87) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wiersema R et al., 2020<a class="elsevierStyleCrossRef" href="#bib0330">27</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">244 (66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">241 (65) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Beaubien-Souligny W et al., 2018<a class="elsevierStyleCrossRef" href="#bib0335">28</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">107 (74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">145 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spiegel R et al., 2020<a class="elsevierStyleCrossRef" href="#bib0340">29</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 (60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 [4–8] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3465233.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Other major surgery(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Politrauma (n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Spontaneous breathing(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-invasive ventilation(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PEEP during NIV(mean±SD; cmH20) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Invasive ventilation(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PEEP during IV(±SD/median [25th–75th percentiles]; cmH20) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Admission SCr(±SD/median [25th–75th percentiles]; mg/dl) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Admission BUN(±SD/median [25th–75th percentiles]; mg/dl) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Admission eGFR (mean±SD; ml/min/1.73m2) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CKD admission(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 [10–14] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 [0.7–2.5] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (23) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">130 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">234 (63) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.9 (±20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (4) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3465235.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Description of the target population of the studies." ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "AKI: acute kidney injury; IRVF: intra renal venous flow; NA: not available; RI: resistive index; RRT: renal replacement therapy; RRT dep: renal replacement therapy dependence." "tablatextoimagen" => array:2 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results(primary endpoint) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results(secondary endpoint) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI 1(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Severe AKIstage 2 or 3(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Requiring RRT(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RI in patients without AKI(mean; %) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RI in patients with AKI(median [25th–75th percentiles] or mean±SD) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inadequate venous renal Doppler sign(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Continuous IRVF(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Demodulated IRVF(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fogagnolo A, et al.<a class="elsevierStyleCrossRef" href="#bib0325">26</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">During lung-protective mechanical ventilation, the renal blood flow is more impaired in patients with SARS-CoV-2 ARDS than in patients with classical ARDS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The Youden index analysis showed that RRI >0.71 was the best cut-off value to predict AKI (sensitivity 90%, specificity 100%). The RRI was also a predictor for RRT (best cut-off 0.77; sensitivity 80%, specificity 92%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.66 [0.60–0.69] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.77 [0.73–0.80] \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (53) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (47) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wiersema R, et al.<a class="elsevierStyleCrossRef" href="#bib0330">27</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The diagnostic accuracy of both RRI and VII was low \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">252 (68) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">106 (42) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">146 (58) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.67 (0.08) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.69 (0.08) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">119 (32) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">128 (51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">124 (49) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Beaubien-Souligny W, et al.<a class="elsevierStyleCrossRef" href="#bib0335">28</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Portal flow pulsatility and severe intrarenal flow alteration are independently associated with subsequent AKI in cardiac surgery patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49 (34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92 (70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (30) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spiegel R, et al.<a class="elsevierStyleCrossRef" href="#bib0340">29</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Abnormalities in hepatic and portal venous Doppler are associated with an increase in MAKE-30. Further research is needed to determine if venous Doppler assessments can be useful measures in assessing right-sided venous congestion in critically ill patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">43 (37) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 (75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 (25) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3465236.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biphasic IRVF(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Monophasic IRVF(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI in continuous IRVF(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI in demodulated IRVF(n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RRT dep (n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">follow up (n, (%)) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">108 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27 (27) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 (51) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 (25) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NA \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3465234.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Results of the studies." ] ] 5 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.doc" "ficheroTamanyo" => 16621 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:37 [ 0 => array:3 [ "identificador" => "bib0200" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of acute kidney injury: how big is the problem?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.A.J. Hoste" 1 => "M. Schurgers" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e318168c590" "Revista" => array:4 [ "tituloSerie" => "Crit Care Med" "fecha" => "2008" "volumen" => "36" "numero" => "Suppl. 4" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0205" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute kidney injury, mortality, length of stay, and costs in hospitalized patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.M. Chertow" 1 => "E. Burdick" 2 => "M. Honour" 3 => "J.V. Bonventre" 4 => "D.W. Bates" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1681/ASN.2004090740" "Revista" => array:6 [ "tituloSerie" => "J Am Soc Nephrol" "fecha" => "2005" "volumen" => "16" "paginaInicial" => "3365" "paginaFinal" => "3370" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16177006" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0210" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "KDIGO clinical practice guidelines for acute kidney injury" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Khwaja" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000339789" "Revista" => array:3 [ "tituloSerie" => "Nephron Clin Pract" "fecha" => "2012" "volumen" => "120" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0215" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Ostermann" 1 => "A. Schneider" 2 => "T. Rimmele" 3 => "I. Bobek" 4 => "M. van Dam" 5 => "M. Darmo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s40635-019-0280-z" "Revista" => array:5 [ "tituloSerie" => "Intensive Care Med Exp" "fecha" => "2019" "volumen" => "7" "paginaInicial" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31811522" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0220" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Monitoring of renal perfusion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Darmon" 1 => "D. Schnell" 2 => "A. Schneider" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00134-022-06857-0" "Revista" => array:7 [ "tituloSerie" => "Intensive Care Med" "fecha" => "2022" "volumen" => "48" "paginaInicial" => "1505" "paginaFinal" => "1507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36053317" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1470204520301108" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0225" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The influence of venous pressure on the isolated mammalian kidney" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F.R. Winton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1113/jphysiol.1931.sp002761" "Revista" => array:6 [ "tituloSerie" => "J Physiol" "fecha" => "1931" "volumen" => "72" "paginaInicial" => "49" "paginaFinal" => "61" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16994199" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0230" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Raised venous pressure: a direct cause of renal sodium retention in oedema?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.D. Firth" 1 => "A.E.G. Raine" 2 => "J.G.G. Ledingham" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(88)91851-X" "Revista" => array:5 [ "tituloSerie" => "Lancet" "fecha" => "1988" "volumen" => "331" "paginaInicial" => "1033" "paginaFinal" => "1036" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0235" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congestive nephropathy: a neglected entity? Proposal for diagnostic criteria and future perspectives" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Husain-Syed" 1 => "H.J. Gröne" 2 => "B. Assmus" 3 => "P. Bauer" 4 => "H. Gall" 5 => "W. Seeger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ehf2.13118" "Revista" => array:2 [ "tituloSerie" => "ESC Heart Fail" "fecha" => "2020" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0240" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic consequences of pulmonary hypertension and right-sided heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Rosenkranz" 1 => "L.S. Howard" 2 => "M. Gomberg-Maitland" 3 => "M.M. Hoeper" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.116.022362" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2020" "volumen" => "141" "paginaInicial" => "678" "paginaFinal" => "693" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32091921" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0245" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.L.N.G. Malbrain" 1 => "N. Van Regenmortel" 2 => "B. Saugel" 3 => "B. De Tavernier" 4 => "P.J. Van Gaal" 5 => "O. Joannes-Boyau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13613-018-0402-x" "Revista" => array:3 [ "tituloSerie" => "Ann Intensive Care" "fecha" => "2018" "volumen" => "8" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0250" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Associations of fluid overload with mortality and kidney recovery in patients with acute kidney injury: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Zhang" 1 => "Z. Chen" 2 => "Y. Diao" 3 => "Y. Yang" 4 => "P. Fu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrc.2015.03.025" "Revista" => array:4 [ "tituloSerie" => "J Crit Care" "fecha" => "2015" "volumen" => "30" "paginaInicial" => "860.e7" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0255" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardio-pulmonary-renal interactions in ICU patients. Role of mechanical ventilation, venous congestion and perfusion deficit on worsening of renal function: insights from the MIMIC-III database" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Geri" 1 => "L. Ferrer" 2 => "N. Tran" 3 => "L.A. Celi" 4 => "M. Jamme" 5 => "J. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrc.2021.03.013" "Revista" => array:6 [ "tituloSerie" => "J Crit Care" "fecha" => "2021" "volumen" => "64" "paginaInicial" => "100" "paginaFinal" => "107" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33845445" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0260" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postoperative blood pressure deficit and acute kidney injury progression in vasopressor-dependent cardiovascular surgery patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Saito" 1 => "S. Uchino" 2 => "M. Takinami" 3 => "S. Uezono" 4 => "R. Bellomo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13054-016-1253-1" "Revista" => array:5 [ "tituloSerie" => "Crit Care" "fecha" => "2016" "volumen" => "20" "paginaInicial" => "1" "paginaFinal" => "8" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0265" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal vein Doppler sonography of obstructive uropathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G.A. Bateman" 1 => "R. Cuganesan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/ajr.178.4.1780921" "Revista" => array:5 [ "tituloSerie" => "Am J Roentgenol" "fecha" => "2002" "volumen" => "178" "paginaInicial" => "921" "paginaFinal" => "925" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0270" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal venous Doppler sonography in preeclampsia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.A. Bateman" 1 => "W. Giles" 2 => "S.L. England" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7863/jum.2004.23.12.1607" "Revista" => array:6 [ "tituloSerie" => "J Ultrasound Med" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "1607" "paginaFinal" => "1611" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15557303" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0275" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal vein Doppler ultrasound of maternal kidneys in normal second and third trimester pregnancy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N. Karabulut" 1 => "A.B. Ya¿ci" 2 => "A. Karabulut" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr/81976752" "Revista" => array:6 [ "tituloSerie" => "Br J Radiol" "fecha" => "2003" "volumen" => "76" "paginaInicial" => "444" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12857702" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0280" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intrarenal venous flow: a window into the congestive kidney failure phenotype of heart failure?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.H.W. Tang" 1 => "T. Kitai" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jchf.2016.05.009" "Revista" => array:6 [ "tituloSerie" => "JACC Heart Fail" "fecha" => "2016" "volumen" => "4" "paginaInicial" => "683" "paginaFinal" => "686" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27395345" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0285" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal venous doppler ultrasonography in normal subjects and patients with diabetic nephropathy: value of venous impedance index measurements" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.H. Jeong" 1 => "D.C. Jung" 2 => "S.H. Kim" 3 => "S.H. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jcu.20835" "Revista" => array:6 [ "tituloSerie" => "J Clin Ultrasound" "fecha" => "2011" "volumen" => "39" "paginaInicial" => "512" "paginaFinal" => "518" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21544829" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0290" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance of Doppler-based resistive index and semi-quantitative renal perfusion in predicting persistent AKI: results of a prospective multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Darmon" 1 => "A. Bourmaud" 2 => "M. Reynaud" 3 => "S. Rouleau" 4 => "F. Meziani" 5 => "A. Boivin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00134-018-5386-3" "Revista" => array:6 [ "tituloSerie" => "Intensive Care Med" "fecha" => "2018" "volumen" => "44" "paginaInicial" => "1904" "paginaFinal" => "1913" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30291377" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0295" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quantifying systemic congestion with point-of-care ultrasound: development of the venous excess ultrasound grading system" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Beaubien-Souligny" 1 => "P. Rola" 2 => "K. Haycock" 3 => "J. Bouchard" 4 => "Y. Lamarche" 5 => "R. Spiegel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13089-020-00163-w" "Revista" => array:3 [ "tituloSerie" => "Ultrasound J" "fecha" => "2020" "volumen" => "12" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0300" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "the PRISMA-DTA Group" "etal" => true "autores" => array:5 [ 0 => "M.D.F. McInnes" 1 => "D. Moher" 2 => "B.D. Thombs" 3 => "T.A. McGrath" 4 => "P.M. Bossuyt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2017.19163" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2018" "volumen" => "319" "paginaInicial" => "388" "paginaFinal" => "396" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29362800" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0305" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.F. Stroup" 1 => "J.A. Berlin" 2 => "S.C. Morton" 3 => "I. Olkin" 4 => "G.D. Williamson" 5 => "D. Rennie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/JAMA.283.15.2008" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2000" "volumen" => "283" "paginaInicial" => "2008" "paginaFinal" => "2012" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10789670" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0310" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.L. Mehta" 1 => "J.A. Kellum" 2 => "S.V. Shah" 3 => "B.A. Molitoris" 4 => "C. Ronco" 5 => "D.G Warnock" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/cc5713" "Revista" => array:3 [ "tituloSerie" => "Crit Care" "fecha" => "2007" "volumen" => "11" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0315" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Bellomo" 1 => "C. Ronco" 2 => "J.A. Kellum" 3 => "R.L. Mehta" 4 => "P. Palevsky" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/cc2872" "Revista" => array:3 [ "tituloSerie" => "Crit Care (London, England)" "fecha" => "2004" "volumen" => "8" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0320" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis in clinical trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T.G.A. Wells" 1 => "B. Shea" 2 => "D. O’Connell" 3 => "J. Peterson" 4 => "V. Welch" 5 => "M. Losos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0197-2456(86)90046-2" "Revista" => array:6 [ "tituloSerie" => "Control Clin Trials" "fecha" => "1986" "volumen" => "7" "paginaInicial" => "177" "paginaFinal" => "188" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3802833" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0325" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Focus on renal blood flow in mechanically ventilated patients with SARS-CoV-2: a prospective pilot study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Fogagnolo" 1 => "S. Grasso" 2 => "M. Dres" 3 => "L. Gesualdo" 4 => "F. Murgolo" 5 => "E. Morelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10877-020-00633-5" "Revista" => array:6 [ "tituloSerie" => "J Clin Monit Comput" "fecha" => "2021" "volumen" => "36" "paginaInicial" => "161" "paginaFinal" => "167" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33385260" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0330" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic accuracy of arterial and venous renal Doppler assessment for acute kidney injury in critically ill patients: a prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Wiersema" 1 => "T. Kaufmann" 2 => "H.N. van der Veen" 3 => "R.J. de Haas" 4 => "C.F.M. Franssen" 5 => "J. Koeze" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrc.2020.05.012" "Revista" => array:6 [ "tituloSerie" => "J Crit Care" "fecha" => "2020" "volumen" => "59" "paginaInicial" => "57" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32526633" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0335" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alterations in portal vein flow and intrarenal venous flow are associated with acute kidney injury after cardiac surgery: a prospective observational cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Beaubien-Souligny" 1 => "A. Benkreira" 2 => "P. Robillard" 3 => "N. Bouabdallaoui" 4 => "M. Chassé" 5 => "G. Desjardins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/JAHA.118.009961" "Revista" => array:3 [ "tituloSerie" => "J Am Heart Assoc" "fecha" => "2018" "volumen" => "7" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0340" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of venous Doppler to predict adverse kidney events in a general ICU cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Spiegel" 1 => "W. Teeter" 2 => "S. Sullivan" 3 => "K. Tupchong" 4 => "N. Mohammed" 5 => "M. Sutherland" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13054-020-03330-6" "Revista" => array:3 [ "tituloSerie" => "Crit Care" "fecha" => "2020" "volumen" => "24" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0345" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Wells" 1 => "B. Shea" 2 => "D. O’Connell" 3 => "J. Peterson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2013" "editorial" => "Ottawa Hospital Research Institute" "editorialLocalizacion" => "Ottawa, ON" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0350" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.S. Levey" 1 => "J. Coresh" 2 => "T. Greene" 3 => "L.A. Stevens" 4 => "Y.L. Zhang" 5 => "S. Hendriksen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7326/0003-4819-145-4-200608150-00004" "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2006" "volumen" => "145" "paginaInicial" => "247" "paginaFinal" => "254" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16908915" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0355" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of major adverse kidney events within the electronic health record" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.W. Semler" 1 => "T.W. Rice" 2 => "A.D. Shaw" 3 => "E.D. Siew" 4 => "W.H. Self" 5 => "A.B. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10916-016-0528-z" "Revista" => array:3 [ "tituloSerie" => "J Med Syst" "fecha" => "2016" "volumen" => "40" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0360" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute kidney injury" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.A. Kellum" 1 => "P. Romagnani" 2 => "G. Ashuntantang" 3 => "C. Ronco" 4 => "A. Zarbock" 5 => "H.J. Anders" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/s41572-021-00284-z" "Revista" => array:3 [ "tituloSerie" => "Nat Rev Dis Primers" "fecha" => "2021" "volumen" => "7" ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0365" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Focused ultrasound training for clinicians" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.L.P. Langlois" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.CCM.0000260625.63077.05" "Revista" => array:4 [ "tituloSerie" => "Crit Care Med" "fecha" => "2007" "volumen" => "35" "numero" => "Suppl." ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0370" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The intrinsic renal compartment syndrome: new perspectives in kidney transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Herrler" 1 => "A. Tischer" 2 => "A. Meyer" 3 => "S. Feiler" 4 => "M. Guba" 5 => "S. Nowak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/TP.0b013e3181c40aba" "Revista" => array:7 [ "tituloSerie" => "Transplantation" "fecha" => "2010" "volumen" => "89" "paginaInicial" => "40" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20061917" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1535610822000599" "estado" => "S300" "issn" => "15356108" ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0385" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Uncertainty in heterogeneity estimates in meta-analyses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.P.A. Ioannidis" 1 => "N.A. Patsopoulos" 2 => "E. Evangelou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/BMJ.39343.408449.80" "Revista" => array:4 [ "tituloSerie" => "BMJ Br Med J" "fecha" => "2007" "volumen" => "335" "paginaInicial" => "914" ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0390" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resistive index or color-Doppler semi-quantitative evaluation of renal perfusion by inexperienced physicians: results of a pilot study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Schnell" 1 => "M. Reynaud" 2 => "M. Venot" 3 => "A.L. Le Maho" 4 => "M. Dinic" 5 => "M. Baulieu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Minerva Anestesiol" "fecha" => "2014" "volumen" => "80" "paginaInicial" => "1273" "paginaFinal" => "1281" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24569358" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/00000043000000S2/v2_202402210544/S2013251423000858/v2_202402210544/en/main.assets" "Apartado" => array:4 [ "identificador" => "42660" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/00000043000000S2/v2_202402210544/S2013251423000858/v2_202402210544/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251423000858?idApp=UINPBA000064"]

Statistics

Original article

Evaluación del flujo venoso intrarrenal mediante Doppler como una nueva herramienta para predecir la lesión renal aguda: revisión sistemática y metaanálisis

Nicholas S.M. Bianchi Bosisioa, Gregorio Romero-Gonzálezb,c, Annalisa De Silvestrid, Faeq Husain-Syade,c, Fiorenza Ferrarif,c,

Corresponding author

fioreferrari28@gmail.com

Corresponding author.

a Department of Medical, Surgical, Diagnostic and Paediatric Science, University of Pavia, Italy

b Department of Nephrology, Hospital Germans Trias i Pujol, Badalona, Spain

c International Renal Research Institute of Vicenza (IRRIV), Vicenza, Italy

d Clinical Epidemiology and Biometrics Service, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

e Department of Internal Medicine II, University Hospital Giessen and Marburg, Justus-Liebig-University Giessen, Giessen, Germany

f Anaesthesiology and Intensive Care Unit 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

Read

1424

Times
was read the article

719

Total PDF

705

Total HTML

Share statistics

 array:23 [
  "pii" => "S2013251423000858"
  "issn" => "20132514"
  "doi" => "10.1016/j.nefroe.2023.05.010"
  "estado" => "S300"
  "fechaPublicacion" => "2023-12-01"
  "aid" => "1153"
  "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
  "copyrightAnyo" => "2023"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Nefrologia &#40;English Version&#41;. 2023;43 Supl 2:57-66"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2013251424000294"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2024.01.019"
    "estado" => "S300"
    "fechaPublicacion" => "2023-12-01"
    "aid" => "1158"
    "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2023;43 Supl 2:67-76"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Short Original</span>"
      "titulo" => "Relationship between biochemical parameters of mineral bone disease and static bone histomorphometry in chronic kidney disease patients on hemodialysis&#58; An Indian cross-section study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "67"
          "paginaFinal" => "76"
        ]
      ]
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Fig&#46; 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 2901
              "Ancho" => 2500
              "Tamanyo" => 209368
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Boxplot showing the impact of age on osteoblast surface &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41; and eroded surface &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;031&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Manish Chaturvedy, Santosh Kumar Maurya, Nitin Kumar Bajpai, Mahendra Kumar Jangid, Poonam Elhence, Abhay Elhence, Akhil Dhanesh Goel, Praveen Sharma, Prem Prakash Sharma, Rajesh Jhorawat"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Manish"
              "apellidos" => "Chaturvedy"
            ]
            1 => array:2 [
              "nombre" => "Santosh Kumar"
              "apellidos" => "Maurya"
            ]
            2 => array:2 [
              "nombre" => "Nitin Kumar"
              "apellidos" => "Bajpai"
            ]
            3 => array:2 [
              "nombre" => "Mahendra Kumar"
              "apellidos" => "Jangid"
            ]
            4 => array:2 [
              "nombre" => "Poonam"
              "apellidos" => "Elhence"
            ]
            5 => array:2 [
              "nombre" => "Abhay"
              "apellidos" => "Elhence"
            ]
            6 => array:2 [
              "nombre" => "Akhil Dhanesh"
              "apellidos" => "Goel"
            ]
            7 => array:2 [
              "nombre" => "Praveen"
              "apellidos" => "Sharma"
            ]
            8 => array:2 [
              "nombre" => "Prem Prakash"
              "apellidos" => "Sharma"
            ]
            9 => array:2 [
              "nombre" => "Rajesh"
              "apellidos" => "Jhorawat"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251424000294?idApp=UINPBA000064"
    "url" => "/20132514/00000043000000S2/v2_202402210544/S2013251424000294/v2_202402210544/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2013251423000846"
    "issn" => "20132514"
    "doi" => "10.1016/j.nefroe.2023.05.009"
    "estado" => "S300"
    "fechaPublicacion" => "2023-12-01"
    "aid" => "1150"
    "copyright" => "Sociedad Espa&#241;ola de Nefrolog&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Nefrologia &#40;English Version&#41;. 2023;43 Supl 2:47-56"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Serum chloride as a marker of cardiovascular and all-cause mortality in chronic hemodialysis patients&#58; 5-Year follow-up study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "47"
          "paginaFinal" => "56"
        ]
      ]
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0035"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2512
              "Ancho" => 2508
              "Tamanyo" => 352112
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier estimates of cumulative all-cause survival rates&#46; Patients were stratified into four groups according to median CRP and Cl<span class="elsevierStyleSup">&#8722;</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Francisco Valga, Tania Monzon, Nicanor Vega-Diaz, Angelo Santana, Giancarlo Moscol, Sergio Ruiz-Santana, Jose Carlos Rodriguez-Perez"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Francisco"
              "apellidos" => "Valga"
            ]
            1 => array:2 [
              "nombre" => "Tania"
              "apellidos" => "Monzon"
            ]
            2 => array:2 [
              "nombre" => "Nicanor"
              "apellidos" => "Vega-Diaz"
            ]
            3 => array:2 [
              "nombre" => "Angelo"
              "apellidos" => "Santana"
            ]
            4 => array:2 [
              "nombre" => "Giancarlo"
              "apellidos" => "Moscol"
            ]
            5 => array:2 [
              "nombre" => "Sergio"
              "apellidos" => "Ruiz-Santana"
            ]
            6 => array:2 [
              "nombre" => "Jose Carlos"
              "apellidos" => "Rodriguez-Perez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251423000846?idApp=UINPBA000064"
    "url" => "/20132514/00000043000000S2/v2_202402210544/S2013251423000846/v2_202402210544/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Doppler-based evaluation of intrarenal venous flow as a new tool to predict acute kidney injury&#58; A systematic review and meta-analysis"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "57"
        "paginaFinal" => "66"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Nicholas S&#46;M&#46; Bianchi Bosisio, Gregorio Romero-Gonz&#225;lez, Annalisa De Silvestri, Faeq Husain-Syad, Fiorenza Ferrari"
        "autores" => array:5 [
          0 => array:3 [
            "nombre" => "Nicholas S&#46;M&#46;"
            "apellidos" => "Bianchi Bosisio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Gregorio"
            "apellidos" => "Romero-Gonz&#225;lez"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Annalisa"
            "apellidos" => "De Silvestri"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Faeq"
            "apellidos" => "Husain-Syad"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:4 [
            "nombre" => "Fiorenza"
            "apellidos" => "Ferrari"
            "email" => array:1 [
              0 => "fioreferrari28@gmail.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Department of Medical&#44; Surgical&#44; Diagnostic and Paediatric Science&#44; University of Pavia&#44; Italy"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Nephrology&#44; Hospital Germans Trias i Pujol&#44; Badalona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "International Renal Research Institute of Vicenza &#40;IRRIV&#41;&#44; Vicenza&#44; Italy"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Clinical Epidemiology and Biometrics Service&#44; Scientific Direction&#44; Fondazione IRCCS Policlinico San Matteo&#44; Pavia&#44; Italy"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Department of Internal Medicine II&#44; University Hospital Giessen and Marburg&#44; Justus-Liebig-University Giessen&#44; Giessen&#44; Germany"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Anaesthesiology and Intensive Care Unit 1&#44; Fondazione IRCCS Policlinico San Matteo&#44; Pavia&#44; Italy"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Evaluaci&#243;n del flujo venoso intrarrenal mediante Doppler como una nueva herramienta para predecir la lesi&#243;n renal aguda&#58; revisi&#243;n sistem&#225;tica y metaan&#225;lisis"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1875
            "Ancho" => 2917
            "Tamanyo" => 156409
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Forest plot of comparison&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The occurrence of acute kidney injury &#40;AKI&#41; in patients admitted to the intensive care unit &#40;ICU&#41; varies between 30&#37; and 60&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">1&#44;2</span></a> AKI is defined as a decrease in kidney function based on elevated serum creatinine &#40;SCr&#41; levels&#44; a decrease in urinary output&#44; or the need for renal replacement therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">3</span></a> Different pathophysiological pathways can lead to the development of AKI in critically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">4</span></a> Renal hypo-perfusion has long been considered as one of the main predisposing factors for AKI in critically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">5</span></a> However&#44; already in 1931&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">6</span></a> the role of venous congestion in worsening renal function came to light&#44; and this historical study demonstrated that glomerular intra-capillary pressure is about two-thirds the renal artery pressure&#46; Reduction in glomerular intra-capillary pressure results in a decrease in renal perfusion pressure and consequent diminution of the glomerular filtrate rate &#40;GFR&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">7</span></a> On the other hand&#44; the effect of increased central venous pressure transmitted through low-resistance renal vessels in encapsulated organs&#44; such as the kidneys&#44; increases renal afterload and intrarenal pressure&#44; driving renal dysfunction and resulting in a condition known as congestive nephropathy&#44; which was recently described as a mechanism of AKI&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">8</span></a> The increase in pressure decreases renal perfusion and intratubular flow&#44; leading to a decrease in GFR&#44; an increase in sodium and water retention mediated by activation of the renin-angiotensin aldosterone system&#44; and tubular damage mediated by the activation of inflammatory mechanisms&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">9</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In the ICU setting&#44; many factors could lead to venous congestion&#44; such as fluid overload&#44;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">9-11</span></a> positive pressure mechanical ventilation&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">12</span></a> right ventricular failure and pulmonary hypertension&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">13</span></a> However&#44; there is no validated diagnostic test to assess whether venous congestion and&#47;or fluid overload play a direct role in impairing renal perfusion&#46; Recently&#44; Doppler-based evaluation of intrarenal vessels has been used for assessing renal haemodynamics&#46; With Doppler imaging&#44; increase in renal venous congestion can be detected through the analysis of renal venous waveforms&#46; Discontinuous intrarenal venous flow &#40;IRVF&#41; patterns suggest an increase in compliance of the renal parenchyma and its venous vessels secondary to increase in venous pressure within the encapsulated kidney&#46;<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">13&#8211;18</span></a> Doppler-based ultrasonography could have high clinical feasibility and acceptable reproducibility for the evaluation of IRVF in a non-invasive way&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19&#44;20</span></a> Therefore&#44; the main objective of this systematic review and meta-analysis is to assess the ability of renal pulsed Doppler &#40;RPD&#41; evaluation of IRVF to predict the development of AKI in critically ill patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Search strategy and eligibility assessment</span><p id="par0015" class="elsevierStylePara elsevierViewall">The present systematic review and meta-analysis were performed according to the general principles of the MOOSE statement<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">21&#44;22</span></a> &#40;<a class="elsevierStyleCrossRef" href="#sec0095">Supplementary Information 2&#41;&#46;</a></p><p id="par0020" class="elsevierStylePara elsevierViewall">We reviewed public-domain databases including Pubmed-MEDLINE&#44; Scopus&#44; Embase and the Cochrane Library&#46; For the search&#44; medical subject heading &#40;MeSH&#41; terms and text words were used with the Boolean strategy&#44; and cross-searches were performed with the following three categories&#58; &#40;1&#41; disease &#40;&#8220;<span class="elsevierStyleItalic">acute kidney injury</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney injury</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">acute renal injury</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal injury</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal failure</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">acute renal failure</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">acute kidney failure</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney failure</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">acute renal damage</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal damage</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">acute kidney damage</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney damage</span>&#8221;&#41; AND &#40;2&#41; tools &#40;&#8220;<span class="elsevierStyleItalic">renal Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal vascular Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">intrarenal Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">intrarenal venous Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">intrarenal vascular Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">intrarenal arterial Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal arterial Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal venous Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal ultrasound</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal echography</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney ultrasound</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney echography</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney vascular Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney arterial Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">kidney venous Doppler</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal resistive index</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">renal venous flow</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">Intrarenal venous flow</span>&#8221;&#41; AND &#40;3&#41; setting &#40;&#8220;<span class="elsevierStyleItalic">intensive care unit</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">critical care</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">critically ill patients</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">critically ill patient</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">critical illness</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">critically ill</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">critical care unit</span>&#8221; <span class="elsevierStyleItalic">OR</span> &#8220;<span class="elsevierStyleItalic">intensive care</span>&#8221;&#41;&#46; The search was restricted to articles published in English and studies on humans published between the 1st of January 2000 and the 31st of December 2021&#46; We considered as type of study for inclusion&#44; the randomised trial and the observational studies&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">All references were downloaded for consolidation&#44; elimination of duplicates and further analysis&#46; Three authors&#44; two intensivist and one nephrologist&#44; &#40;NSMBB&#44; GRG and FF&#41; independently determined the eligibility of all the studies identified in the initial research&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Data extraction</span><p id="par0030" class="elsevierStylePara elsevierViewall">Two authors &#40;NSMBB and GRG&#41; carried out data extraction independently&#46; Disagreements between the two were resolved by a third investigator &#40;FF&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">We framed the search around a PICOS &#40;participants&#44; intervention&#44; comparison&#44; outcomes&#44; study design&#41; model to determine the eligibility criteria of the studies to be included in this systematic review&#46; The participants of interest were critically ill adult patients &#62;18 years old admitted to any kind of ICU&#46; Patients with end-stage chronic kidney disease and those who had undergone renal transplant were excluded&#46; &#8220;<span class="elsevierStyleItalic">Intervention</span>&#8221; was considered as the execution of the RPD with the venous pattern at the time of ICU admission&#44; and the comparison was IRVF pattern related to AKI occurrence&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The outcome of interest was the association between Doppler-based intrarenal venous flow demodulation &#40;any IRVF pattern that is not continuous&#41; and AKI&#46; We included studies that diagnosed AKI based on the AKIN&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">23</span></a> RIFLE<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">24</span></a> diagnosed AKI based and KDIGO<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">3</span></a> criteria&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The study design included prospective and retrospective observational studies and randomised clinical trials&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">We conducted all the analyses using the statistical package STATA 13&#46; We statistically analysed the dichotomous outcomes using risk ratios &#40;RRs&#41; as the summary statistic&#46; Data were pooled only for studies that reported sufficiently similar clinical and methodological variables&#46; A pooled estimate of the RR was computed using the DerSimonian and Laird random-effects model&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">25</span></a> This calculation provides an appropriate estimate of the average treatment effect when studies are statistically heterogeneous&#46; Heterogeneity among the studies was assessed by the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> test and a null hypothesis test&#44; in which <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;1 was considered to indicate significant outcome heterogeneity&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">The literature search yielded 1143 potentially relevant articles&#44; of which 182 were excluded because they were duplicates&#46; Among the 961 remaining articles&#44; 848 were excluded because they were irrelevant based on the scope of this review &#40;45 were not published in English&#59; 450 were abstracts&#44; letters&#44; conference articles&#44; reviews&#44; or meta-analyses&#59; 48 were conducted on non-human subjects&#59; 51 included children&#59; and 254 included non-critically ill patients&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The full texts of the remaining 113 articles were reviewed independently by two investigators &#40;NSMBB and GRG&#41; for further evaluation&#46; Of these 113 articles&#44; 109 were excluded because they did not include Doppler-based intrarenal venous flow evaluation &#40;58 did not include any kind of RPD measurements&#44; and 51 reported only arterial RPD measurements&#41;&#46; Finally&#44; four studies<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#8211;27</span></a> fulfilled our eligibility criteria and were included &#40;<a class="elsevierStyleCrossRef" href="#fig1">Fig&#46; 1</a> and <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Characteristics of the included studies and participants</span><p id="par0065" class="elsevierStylePara elsevierViewall">The included studies were conducted between 2016 and 2020 and enrolled a total of 660 patients&#46; All of them were single-centre prospective cohort studies &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Two of the studies were conducted in Europe and included a total of 401 &#40;60&#46;75&#37;&#41; patients &#40;of whom 371 were part of a Netherlands study<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> and 30 were part of an Italian study<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a>&#41;&#44; and two were conducted in North America on a total of 259 &#40;39&#46;25&#37;&#41; patients &#40;145 were recruited in a USA study<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a> and 114 were recruited in a Canadian study<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a>&#41;&#46; Of the 660 participants&#44; 444 &#40;67&#46;27&#37;&#41; were males with an age range of 57&#8211;66 years &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The race of the participants was only specified by Spiegel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a>&#58; 58 &#40;50&#46;90&#37;&#41; were Caucasians&#44; 49 &#40;42&#46;90&#37;&#41; were Africans and 2 &#40;1&#46;8&#37;&#41; were Asians&#46; The reported diagnosis of the patients varied across studies&#58; 275 &#40;41&#46;67&#37;&#41; were scheduled for surgery<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#44;26</span></a> &#40;of whom 145 underwent elective cardiac surgery<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a>&#41;&#44; 26 &#40;3&#46;94&#37;&#41; had septic shock<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#8211;27</span></a> and 26 &#40;3&#46;94&#37;&#41; had non-categorised Adults Respiratory Distress Syndrome &#40;ARDS&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a> However&#44; the diagnosis at admission was not defined clearly in 241 cases &#40;36&#46;52&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> and a diagnosis was lacking at the time of admission in 92 &#40;13&#46;94&#37;&#41; patients&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a> The most recent study included 15 &#40;2&#46;27&#37;&#41; COVID-19 patients&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a> Three of the selected studies<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#44;25&#44;27</span></a> were performed in a multidisciplinary ICU &#40;these three studies included 515 patients or 78&#46;03&#37; of the total participants included in this review&#41;&#44; while the fourth one<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> was conducted in a specific post-cardiac surgery ICU &#40;this study included 145 patients or 21&#46;97&#37; of the total participants&#41;&#46; Severity score was determined in two studies<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#44;27</span></a>&#59; both studies reported the SOFA score to range from 7 to 8 &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Study quality assessment</span><p id="par0075" class="elsevierStylePara elsevierViewall">The quality of studies was assessed using the risk-of-bias method recommended by the Newcastle&#8211;Ottawa quality assessment scale for cohort studies&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">30</span></a> FF&#44; NSMBB and GRG individually assessed the scores&#44; which are presented in <a class="elsevierStyleCrossRef" href="#sec0095">Supplementary Information 1</a>&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Definition of renal function and AKI</span><p id="par0080" class="elsevierStylePara elsevierViewall">Fogagnolo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a> defined renal function based on SCr level&#44; and Beaubien-Souligny et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> defined renal function based on eGFR with the MDRD formula&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">31</span></a> However&#44; renal function was not defined in the other two studies<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#44;27</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Three studies<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#8211;26</span></a> defined AKI according to the KDIGO guidelines&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">3</span></a> without introducing any definition of the baseline SCr level&#46; Spiegel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a> adopted major adverse kidney event &#40;MAKE-30&#41;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">32</span></a> as the primary outcome &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Renal pulsed Doppler examination imaging quality&#44; investigator&#44; and timing</span><p id="par0090" class="elsevierStylePara elsevierViewall">Although assessment of both kidneys is preferable&#44; the right kidney is generally more accessible&#46; Therefore&#44; all selected studies have limited the investigation to this side&#46; The RPD examination was performed by investigators trained in RPD&#44;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#8211;27</span></a> under the supervision of a radiologist&#44;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#44;26</span></a> a single well-trained anaesthesiologist with certified experience in examination of the right kidney&#44;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a> or a critical care fellow with 1-month clinical training in POCUS and transthoracic echocardiography&#46; The inter-rater reliability between examiners or supervisors was evaluated only in two studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">26&#44;27</span></a> and the method used was described in only one of these studies&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> In two studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#44;26</span></a> the investigators were blinded to the clinical and laboratory data&#46; In the Spiegel et al&#46; study&#44; the images&#44; interpretations and recommendations for care were not discussed with or made available to the treating clinicians&#44; and Doppler waveforms were reviewed by two members of the research team who were blinded to the clinical outcomes&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a> In one study&#44;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> it was not disclosed whether the examiner was blinded to the patient data&#46; Three studies<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#8211;27</span></a> reported that the venous renal RPD signal was inadequate&#46; This meant that 162 &#40;24&#46;54&#37;&#41; of the patients did not have an IRVF evaluation &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Wieserma et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a> performed RPD upon inclusion &#40;mean time to inclusion was 13<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7<span class="elsevierStyleHsp" style=""></span>h&#41;&#59; Spiegel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> and Fogagnolo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">25</span></a> within 24<span class="elsevierStyleHsp" style=""></span>h from ICU admission and from the invasive mechanical ventilation start&#44; respectively&#46; Souligny et al&#46; planned a preoperative ultrasound assessment<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> and only they repeated the exam at Day &#35;1&#44; &#35;2&#44; &#35;3 after the surgery&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">AKI occurrence and Doppler-based evaluation of IRVF for the prediction of AKI</span><p id="par0095" class="elsevierStylePara elsevierViewall">AKI occurrence ranged between 34&#37; and 68&#37;&#46; Severe AKI &#40;KDIGO stage 2 and 3&#41; occurrence was only found in two studies<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#44;26</span></a>&#58; it was reported in 58&#37;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a> and 7&#37;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> of the AKI patients &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; Beaubien-Souligny demonstrated an association between monophasic venous flow and any AKI stage &#40;HR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;81&#59; 95&#37; CI 1&#46;42&#8211;5&#46;56&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#46; Fogagnolo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">25</span></a> described a higher percentage of an impaired IRVF &#40;13&#47;13 in AKI group vs 1&#47;17 in no AKI group&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; in the patients who developed AKI&#46; On the other hand&#44; Spiegel et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> demonstrated that the biphasic or monophasic patterns were not associated with an increase in the rate of MAKE-30 events in their cohort&#44; as well as no difference was observed in IRVF patterns between patients with and without AKI by Wiersema et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">No study analysed the association between the IRVF patterns and the ethiology of AKI or with the renal recovery&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">All the studies we reviewed had investigated the RPD venous pattern&#46; We used data obtained from three<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">26&#8211;28</span></a> of these in our metanalysis &#40;in total 413 patients&#44; because an inadequate venous RPD sign was found in 113 patients&#46; One study<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a> was excluded because its data were inadequate for pooling&#46; We found a significant difference between patients who had RPD continuous flow and demodulated IRVF &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;46&#59; 95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;28&#8211;0&#46;76&#59; <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Further&#44; our results revealed significant heterogeneity across the studies &#40;<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>68&#46;7&#37;&#59; 95&#37; CI 0&#8211;90&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">Adequate preventive and curative strategies for AKI are still lacking&#46; Indeed&#44; SCr&#44; the most widely used biomarker for diagnosing AKI that is available worldwide&#44; has poor specificity&#44; results in delayed diagnosis&#44; and does not provide prompt detection of tubular injury&#46; In addition&#44; SCr kinetics and other factors &#40;such as catabolism&#44; fluid overload&#44; nutrition and lean tissue status&#41; can postpone or confound the diagnosis in critically ill patients&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">3</span></a> Other diagnostic methods&#44; such as detection of new biomarkers&#44; have been studied with regard to their ability for prediction&#44; timely diagnosis and risk stratification of AKI&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">33</span></a> However&#44; the diffusion of these diagnostic tools is still limited&#44; and their cost cannot be borne in low- and middle-income countries&#46; As a result of this situation&#44; ultrasound scanning has become a reliable tool for clinicians in the emergency and critical care setting&#44;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">34</span></a> but in the ICU setting&#44; RPD still has limited use compared with lung ultrasonography and echocardiography&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Renal resistive index &#40;RRI&#41; and IRVF are the parameters used to assess renal perfusion and congestion&#46; In the kidneys&#44; which are capsulated organs&#44; interstitial oedema resulting from renal insult translates into increased subcapsular pressure that ultimately causes a decrease in renal perfusion<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">35</span></a> and is likely to cause a decrease in renal vascular compliance while increasing RRI&#46; Additionally&#44; kidneys are also affected by increased intrabdominal pressure that could be related to abnormalities in the abdomen itself or transmission of raised airway pressure in a stiffened lung through the diaphragm&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">34&#44;35</span></a> In such situations&#44; IRVF could be beneficial as it can suggest increased pressure in a close compartment&#44; such as Gerota&#39;s capsule&#46; Waveforms detected by ultrasound can not only reflect kidney injury&#44; but also indicate the severity of congestion&#46; Therefore&#44; waveforms have prognostic significance and can be used to monitor the efficacy of a therapy&#46; Moreover&#44; as point-of-care ultrasonography can be performed by experts at the patient&#39;s bedside&#44; immediate clinical integration of the imaging data is possible&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In the present systematic review and meta-analysis&#44; we explored the ability of Doppler-based evaluation of IRVF demodulation in predicting the development of AKI in critically ill patients&#46; Notably&#44; our findings also provide several insights that go beyond the primary objective of the study&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Our results indicated that patients with continuous IRVF had less than half the risk of developing AKI than patients with demodulated IRVF&#46; All selected studies contributed to this result &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">However&#44; despite the high quality of the included studies&#44; our metanalysis showed a significant heterogeneity&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">This heterogeneity may be partially explained by the small number of studies included in the metanalysis&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">36</span></a> On the other hand&#44; based on the PICOS criteria&#44; we identified adult critically ill patients&#44; but we could not find a uniform target population&#46; Many factors differentiate the population of the selected studies&#46; The age of the population ranged from 57 to 66 years&#44; and male sex was prevalent in all the studies&#46; Severity scores were reported in only two studies&#44; both of which exclusively calculated the SOFA scores&#44;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#44;27</span></a> then we could not compare the severity of the illness of each study population&#46; The diagnosis for which the patient was admitted to the ICU was not clearly defined in 241 cases &#40;36&#46;52&#37;&#41; and there was no diagnosis at admission in 92 &#40;13&#46;94&#37;&#41; patients&#46; Furthermore&#44; the multidisciplinary nature of some TI studies suggests a varied melting pot of diagnoses and degrees of severity&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Bedsides&#44; RPD examination was performed in critically ill patients with various diagnoses at the time of ICU admission and in only one study<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a> RPD has been revaluated during ICU stay&#46; Finally&#44; AKI was defined based on the KDIGO guidelines in three of the studies&#44; but only some of the data described renal function at the time of admission or baseline kidney function&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">RPD examination was performed by investigators trained under the supervision of a single well-trained anaesthesiologist with certified experience or a critical care fellow with 1-month clinical training in POCUS and transthoracic echocardiography&#46; The inter-rater reliability between examinators or supervisors was evaluated in two studies&#44; but the method used was described in only one&#46; RPD examination could not be performed in 24&#46;54&#37; of the patients&#44; but the authors did not clearly explain the reason why it could not be performed or the limits of its feasibility and reliability&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">However&#44; the evaluation of RRI and IRVF is fast&#44; non-invasive and repeatable&#44; and can be performed in most patients by inexperienced operators after a half-day course&#46;<span class="elsevierStyleSup">39</span> In critically ill patients&#44; the interobserver reproducibility between a senior and inexperienced operator is good and the measures seem accurate &#40;as indicated by the absence of systematic bias in the reviewed studies&#41;&#44; although a lack of precision was found &#40;based on an interobserver 95&#37; confidence interval of &#177;0&#46;1&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">37</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0155" class="elsevierStylePara elsevierViewall">Despite its limitations&#44; IRVF is useful for detecting venous congestion and congestive nephropathy&#44; which are associated with impaired renal function&#46; Although the preliminary results in this field are promising&#44; nowadays controversial results have been published in this setting&#46; The heterogeneity of our metanalyses demonstrates once again that confirmatory studies are still needed to assess the feasibility of using IRVF measured with RPD as a predictor of AKI in critically ill patients&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Authors&#8217; contributions</span><p id="par0160" class="elsevierStylePara elsevierViewall">NSMBB conceived the study and participated in study design&#44; acquisition of data&#44; interpretation of data&#44; drafting of the manuscript&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">GAR participated in acquisition of data and participated in critical revision of the manuscript&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">ADS performed the statistical analysis&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">FF participated in study concept&#44; design and coordination&#44; statistical analysis and interpretation of data&#44; drafting of the manuscript&#44; and critical revision of the manuscript&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">FHS&#44; participated in critical revision of the manuscript&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">FF&#44; NSMBB had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">All authors read and approved the final manuscript&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0195" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0200" class="elsevierStylePara elsevierViewall">The authors have declared that no conflict of interest exists&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres2093832"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1784628"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres2093831"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1784627"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Search strategy and eligibility assessment"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Data extraction"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Results"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Characteristics of the included studies and participants"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Study quality assessment"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Definition of renal function and AKI"
            ]
            3 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Renal pulsed Doppler examination imaging quality&#44; investigator&#44; and timing"
            ]
            4 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "AKI occurrence and Doppler-based evaluation of IRVF for the prediction of AKI"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Authors&#8217; contributions"
        ]
        10 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Funding"
        ]
        11 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Conflict of interest"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2022-08-15"
    "fechaAceptado" => "2023-03-14"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1784628"
          "palabras" => array:6 [
            0 => "Renal ultrasound"
            1 => "Renal venous pulsed Doppler"
            2 => "VExUS"
            3 => "Acute kidney injury"
            4 => "Congestive nephropathy"
            5 => "Intrarenal venous flow"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1784627"
          "palabras" => array:6 [
            0 => "Ecograf&#237;a renal"
            1 => "Doppler pulsado renal"
            2 => "VExUS"
            3 => "Lesi&#243;n renal aguda"
            4 => "Nefropat&#237;a congestiva"
            5 => "Flujo venoso intrarrenal"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Congestion is a common complication in the critical care setting&#44; these patients are at increased risk of developing acute kidney injury &#40;AKI&#41;&#46; Congestive nephropathy &#40;CN&#41; has recently been described as a mechanism of worsening renal function&#44; and evaluation of renal venous flow by pulsed Doppler &#40;PD&#41; is a useful tool to assess the presence of renal vein congestion&#46; We comprehensively explore the ability of the PD in the evaluation of the intrarenal venous flow &#40;IRVF&#41; to predict the development of AKI in critically ill patients&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We searched Pubmed-MEDLINE&#44; Scopus&#44; Embase&#44; and Cochrane Library of Systematic Reviews &#40;to 31th December 2021&#41;&#46; We evaluated the association between <span class="elsevierStyleItalic">Doppler-based Intrarenal venous flow demodulation and AKI</span>&#46; CN was defined as the presence of a pulsatile pattern &#40;biphasic or monophasic&#41; in the PD&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 4 articles &#40;660 patients&#41; were included in our systematic review&#44; three of these in the metanalysis &#40;413 patients&#41;&#58; one study was excluded because its data were inadequate for pooling&#46; Two studies originated in Europe and the other two in the United States&#46; AKI occurrence ranged between 34 and 68&#37;&#46; Patients who developed AKI had a significant difference in PD pattern &#40;continuous vs&#46; pulsatile&#41; in the IRVF &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;46&#59; 95&#37; CI 0&#46;28&#8211;0&#46;76&#41;&#46; Nevertheless&#44; a large heterogeneity was observed among the studies &#40;<span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>68&#46;7&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Albeit preliminary&#44; these findings suggest that the presence of a pulsatile pattern in the PD of the IRVF may be involved in the development of AKI in the critically ill patient&#46; The effect of alterations in the IRVF and renal function warrant further investigation&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La congesti&#243;n es una complicaci&#243;n frecuente en el entorno de las unidades de cuidado cr&#237;tico&#44; y estos pacientes tienen un mayor riesgo de desarrollar una lesi&#243;n renal aguda &#40;LRA&#41;&#46; La nefropat&#237;a congestiva &#40;NC&#41; se ha descrito recientemente como un mecanismo de deterioro de la funci&#243;n renal&#44; y la evaluaci&#243;n del flujo venoso renal mediante Doppler pulsado &#40;DP&#41; es una herramienta &#250;til para valorar la presencia de congesti&#243;n venosa renal&#46; Exploramos de forma exhaustiva la capacidad del DP en la evaluaci&#243;n del flujo venoso intrarrenal &#40;FVIR&#41; para predecir el desarrollo de LRA en pacientes en estado cr&#237;tico&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realizaron b&#250;squedas en Pubmed-MEDLINE&#44; Scopus&#44; Embase y la Biblioteca Cochrane de Revisiones Sistem&#225;ticas &#40;hasta el 31 de diciembre de 2021&#41;&#46; Se evalu&#243; la asociaci&#243;n entre la demodulaci&#243;n del flujo venoso intrarrenal basada en Doppler y la LRA&#46; La NC se defini&#243; como la presencia de un patr&#243;n puls&#225;til &#40;bif&#225;sico o monof&#225;sico&#41; en el DP&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron un total de 4 art&#237;culos &#40;660 pacientes&#41; en nuestra revisi&#243;n sistem&#225;tica&#44; tres de ellos en el metaan&#225;lisis &#40;413 pacientes&#41;&#58; se excluy&#243; un estudio porque sus datos eran inadecuados para el an&#225;lisis&#46; Dos estudios proced&#237;an de Europa y los otros dos de Estados Unidos&#46; La aparici&#243;n de LRA oscil&#243; entre el 34 y el 68&#37;&#46; Los pacientes que desarrollaron LRA presentaban una diferencia significativa en el patr&#243;n de DP &#40;continua frente a puls&#225;til&#41; en el FVIR &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;46&#59; IC del 95&#37;&#58; 0&#44;28-0&#44;76&#41;&#46; No obstante&#44; se observ&#243; una gran heterogeneidad entre los estudios &#40;I<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>68&#44;7&#37;&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Aunque preliminares&#44; estos hallazgos sugieren que la presencia de un patr&#243;n puls&#225;til en el DP del FVIR puede estar asociado al desarrollo de la LRA en el paciente cr&#237;tico&#46; El efecto de las alteraciones en el FVIR y la funci&#243;n renal obligan a desarrollar futuras investigaciones&#46;</p></span>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0215" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0095"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2554
            "Ancho" => 1675
            "Tamanyo" => 199970
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The MOOSE flow diagram of study selection&#46; The flow diagram shows the flow of information through the different phases of the systematic review&#58; the number of records identified&#44; included and excluded&#44; and the reasons for exclusions &#40;see study selection paragraph for details&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1875
            "Ancho" => 2917
            "Tamanyo" => 156409
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Forest plot of comparison&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study country&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study period&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study population&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample size &#40;<span class="elsevierStyleItalic">n</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SCr dosing method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">eGFR estimation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Primary endpoint&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Secondary endpoint&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI definition&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fogagnolo A et al&#46;&#44; 2021<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Italy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-centre prospective observational cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Critically ill patients with SARS-COV-2 ARDS or other aetiology ARDS undergoing mechanical ventilation without AKI before ICU admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Assess if the degree of renal blood flow impairment in SARS-COV-2 ARDS compared to other aetiology ARDS could be more pronunced&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Investigate the ability of RRI to predict the occurrence of AKI and the need of RRT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">KDIGO criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wiersema R et al&#46;&#44; 2020<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Netherlands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 May 2018&#8211;10 July 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-centre prospective observational cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Critically ill patients&#44; above 18 years of age&#44; acutely admitted&#44; expected ICU stay at least 24<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">371&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Assess the diagnostic accuracy of the RRI and VII for persistent AKI in a large heterogeneous cohort of critically ill patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">KDIGO criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beaubien-Souligny W et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Canada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">August 2016&#8211;July 2017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-centre prospective observational cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Patients 18 years and older undergoing cardiac surgery with the use of cardiopulmonary bypass without severe CKD or renal transplantation&#44; critical preoperative state and documented AKI or delirium before surgery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enzymatic assay &#40;IDMS-standardised&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MDRD formula&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Development of AKI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">KDIGO criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spiegel R et al&#46;&#44; 2020<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">USA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">January 2019&#8211;June 2019&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single-centre prospective observational cohort&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Adult patients admitted to medica&#44; surgical&#44; trauma or neurotrauma ICUs&#46; Patients with ESRD on outpatient hemodialysis&#44; transplanted kidney or liver were ecluded&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Major adverse kidney event within 30 days &#40;MAKE-30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">MAKE-30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3465237.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the selected studies&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Males&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#47;median &#91;25th&#8211;75th percentiles&#93;&#44; years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SAPSII&#40;median &#91;25th&#8211;75th percentiles&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">APACHE&#40;median &#91;25th&#8211;75th percentiles&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SOFA&#40;median &#91;25th&#8211;75th percentiles&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ARDS &#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Septic shock&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cardiogenic shock&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Other shock&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-well defined medical admission&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Cardiac surgery &#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fogagnolo A et al&#46;&#44; 2021<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#91;60&#8211;72&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#91;5&#8211;10&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wiersema R et al&#46;&#44; 2020<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">244 &#40;66&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">241 &#40;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beaubien-Souligny W et al&#46;&#44; 2018<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">107 &#40;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">145 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spiegel R et al&#46;&#44; 2020<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#91;4&#8211;8&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3465233.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Other major surgery&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Politrauma &#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Spontaneous breathing&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Non-invasive ventilation&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PEEP during NIV&#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#59; cmH20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Invasive ventilation&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PEEP during IV&#40;&#177;SD&#47;median &#91;25th&#8211;75th percentiles&#93;&#59; cmH20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Admission SCr&#40;&#177;SD&#47;median &#91;25th&#8211;75th percentiles&#93;&#59; mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Admission BUN&#40;&#177;SD&#47;median &#91;25th&#8211;75th percentiles&#93;&#59; mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Admission eGFR &#40;mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#59; ml&#47;min&#47;1&#46;73<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CKD admission&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#91;10&#8211;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;0 &#91;0&#46;7&#8211;2&#46;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">234 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#46;9 &#40;&#177;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3465235.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Description of the target population of the studies&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">AKI&#58; acute kidney injury&#59; IRVF&#58; intra renal venous flow&#59; NA&#58; not available&#59; RI&#58; resistive index&#59; RRT&#58; renal replacement therapy&#59; RRT dep&#58; renal replacement therapy dependence&#46;</p>"
          "tablatextoimagen" => array:2 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results&#40;primary endpoint&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Results&#40;secondary endpoint&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI 1&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Severe AKIstage 2 or 3&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Requiring RRT&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RI in patients without AKI&#40;mean&#59; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RI in patients with AKI&#40;median &#91;25th&#8211;75th percentiles&#93; or mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inadequate venous renal Doppler sign&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Continuous IRVF&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Demodulated IRVF&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fogagnolo A&#44; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">During lung-protective mechanical ventilation&#44; the renal blood flow is more impaired in patients with SARS-CoV-2 ARDS than in patients with classical ARDS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The Youden index analysis showed that RRI &#62;0&#46;71 was the best cut-off value to predict AKI &#40;sensitivity 90&#37;&#44; specificity 100&#37;&#41;&#46; The RRI was also a predictor for RRT &#40;best cut-off 0&#46;77&#59; sensitivity 80&#37;&#44; specificity 92&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;66 &#91;0&#46;60&#8211;0&#46;69&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;77 &#91;0&#46;73&#8211;0&#46;80&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;53&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Wiersema R&#44; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">The diagnostic accuracy of both RRI and VII was low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">252 &#40;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">106 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146 &#40;58&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;67 &#40;0&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;69 &#40;0&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">119 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">128 &#40;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beaubien-Souligny W&#44; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Portal flow pulsatility and severe intrarenal flow alteration are independently associated with subsequent AKI in cardiac surgery patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;34&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spiegel R&#44; et al&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abnormalities in hepatic and portal venous Doppler are associated with an increase in MAKE-30&#46; Further research is needed to determine if venous Doppler assessments can be useful measures in assessing right-sided venous congestion in critically ill patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3465236.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Biphasic IRVF&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Monophasic IRVF&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI in continuous IRVF&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AKI in demodulated IRVF&#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RRT dep &#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">follow up &#40;<span class="elsevierStyleItalic">n</span>&#44; &#40;&#37;&#41;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3465234.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Results of the studies&#46;</p>"
        ]
      ]
      5 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.doc"
          "ficheroTamanyo" => 16621
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:37 [
            0 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of acute kidney injury&#58; how big is the problem&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;A&#46;J&#46; Hoste"
                            1 => "M&#46; Schurgers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e318168c590"
                      "Revista" => array:4 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2008"
                        "volumen" => "36"
                        "numero" => "Suppl&#46; 4"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute kidney injury&#44; mortality&#44; length of stay&#44; and costs in hospitalized patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;M&#46; Chertow"
                            1 => "E&#46; Burdick"
                            2 => "M&#46; Honour"
                            3 => "J&#46;V&#46; Bonventre"
                            4 => "D&#46;W&#46; Bates"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1681/ASN.2004090740"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Soc Nephrol"
                        "fecha" => "2005"
                        "volumen" => "16"
                        "paginaInicial" => "3365"
                        "paginaFinal" => "3370"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16177006"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "KDIGO clinical practice guidelines for acute kidney injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Khwaja"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000339789"
                      "Revista" => array:3 [
                        "tituloSerie" => "Nephron Clin Pract"
                        "fecha" => "2012"
                        "volumen" => "120"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Report of the first AKI Round Table meeting&#58; an initiative of the ESICM AKI Section"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Ostermann"
                            1 => "A&#46; Schneider"
                            2 => "T&#46; Rimmele"
                            3 => "I&#46; Bobek"
                            4 => "M&#46; van Dam"
                            5 => "M&#46; Darmo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s40635-019-0280-z"
                      "Revista" => array:5 [
                        "tituloSerie" => "Intensive Care Med Exp"
                        "fecha" => "2019"
                        "volumen" => "7"
                        "paginaInicial" => "69"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31811522"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Monitoring of renal perfusion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Darmon"
                            1 => "D&#46; Schnell"
                            2 => "A&#46; Schneider"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-022-06857-0"
                      "Revista" => array:7 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2022"
                        "volumen" => "48"
                        "paginaInicial" => "1505"
                        "paginaFinal" => "1507"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36053317"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1470204520301108"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The influence of venous pressure on the isolated mammalian kidney"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;R&#46; Winton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1113/jphysiol.1931.sp002761"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Physiol"
                        "fecha" => "1931"
                        "volumen" => "72"
                        "paginaInicial" => "49"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16994199"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Raised venous pressure&#58; a direct cause of renal sodium retention in oedema&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;D&#46; Firth"
                            1 => "A&#46;E&#46;G&#46; Raine"
                            2 => "J&#46;G&#46;G&#46; Ledingham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(88)91851-X"
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1988"
                        "volumen" => "331"
                        "paginaInicial" => "1033"
                        "paginaFinal" => "1036"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congestive nephropathy&#58; a neglected entity&#63; Proposal for diagnostic criteria and future perspectives"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "F&#46; Husain-Syed"
                            1 => "H&#46;J&#46; Gr&#246;ne"
                            2 => "B&#46; Assmus"
                            3 => "P&#46; Bauer"
                            4 => "H&#46; Gall"
                            5 => "W&#46; Seeger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ehf2.13118"
                      "Revista" => array:2 [
                        "tituloSerie" => "ESC Heart Fail"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Systemic consequences of pulmonary hypertension and right-sided heart failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Rosenkranz"
                            1 => "L&#46;S&#46; Howard"
                            2 => "M&#46; Gomberg-Maitland"
                            3 => "M&#46;M&#46; Hoeper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.116.022362"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2020"
                        "volumen" => "141"
                        "paginaInicial" => "678"
                        "paginaFinal" => "693"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32091921"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Principles of fluid management and stewardship in septic shock&#58; it is time to consider the four D&#39;s and the four phases of fluid therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;L&#46;N&#46;G&#46; Malbrain"
                            1 => "N&#46; Van Regenmortel"
                            2 => "B&#46; Saugel"
                            3 => "B&#46; De Tavernier"
                            4 => "P&#46;J&#46; Van Gaal"
                            5 => "O&#46; Joannes-Boyau"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13613-018-0402-x"
                      "Revista" => array:3 [
                        "tituloSerie" => "Ann Intensive Care"
                        "fecha" => "2018"
                        "volumen" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Associations of fluid overload with mortality and kidney recovery in patients with acute kidney injury&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46; Zhang"
                            1 => "Z&#46; Chen"
                            2 => "Y&#46; Diao"
                            3 => "Y&#46; Yang"
                            4 => "P&#46; Fu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2015.03.025"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Crit Care"
                        "fecha" => "2015"
                        "volumen" => "30"
                        "paginaInicial" => "860&#46;e7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardio-pulmonary-renal interactions in ICU patients&#46; Role of mechanical ventilation&#44; venous congestion and perfusion deficit on worsening of renal function&#58; insights from the MIMIC-III database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Geri"
                            1 => "L&#46; Ferrer"
                            2 => "N&#46; Tran"
                            3 => "L&#46;A&#46; Celi"
                            4 => "M&#46; Jamme"
                            5 => "J&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2021.03.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Crit Care"
                        "fecha" => "2021"
                        "volumen" => "64"
                        "paginaInicial" => "100"
                        "paginaFinal" => "107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33845445"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Postoperative blood pressure deficit and acute kidney injury progression in vasopressor-dependent cardiovascular surgery patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Saito"
                            1 => "S&#46; Uchino"
                            2 => "M&#46; Takinami"
                            3 => "S&#46; Uezono"
                            4 => "R&#46; Bellomo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-016-1253-1"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2016"
                        "volumen" => "20"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal vein Doppler sonography of obstructive uropathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;A&#46; Bateman"
                            1 => "R&#46; Cuganesan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/ajr.178.4.1780921"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Roentgenol"
                        "fecha" => "2002"
                        "volumen" => "178"
                        "paginaInicial" => "921"
                        "paginaFinal" => "925"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal venous Doppler sonography in preeclampsia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;A&#46; Bateman"
                            1 => "W&#46; Giles"
                            2 => "S&#46;L&#46; England"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7863/jum.2004.23.12.1607"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Ultrasound Med"
                        "fecha" => "2004"
                        "volumen" => "23"
                        "paginaInicial" => "1607"
                        "paginaFinal" => "1611"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15557303"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal vein Doppler ultrasound of maternal kidneys in normal second and third trimester pregnancy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Karabulut"
                            1 => "A&#46;B&#46; Ya¿ci"
                            2 => "A&#46; Karabulut"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1259/bjr/81976752"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Radiol"
                        "fecha" => "2003"
                        "volumen" => "76"
                        "paginaInicial" => "444"
                        "paginaFinal" => "447"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12857702"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intrarenal venous flow&#58; a window into the congestive kidney failure phenotype of heart failure&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "W&#46;H&#46;W&#46; Tang"
                            1 => "T&#46; Kitai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jchf.2016.05.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Heart Fail"
                        "fecha" => "2016"
                        "volumen" => "4"
                        "paginaInicial" => "683"
                        "paginaFinal" => "686"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27395345"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Renal venous doppler ultrasonography in normal subjects and patients with diabetic nephropathy&#58; value of venous impedance index measurements"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;H&#46; Jeong"
                            1 => "D&#46;C&#46; Jung"
                            2 => "S&#46;H&#46; Kim"
                            3 => "S&#46;H&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/jcu.20835"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Ultrasound"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "paginaInicial" => "512"
                        "paginaFinal" => "518"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21544829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Performance of Doppler-based resistive index and semi-quantitative renal perfusion in predicting persistent AKI&#58; results of a prospective multicenter study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Darmon"
                            1 => "A&#46; Bourmaud"
                            2 => "M&#46; Reynaud"
                            3 => "S&#46; Rouleau"
                            4 => "F&#46; Meziani"
                            5 => "A&#46; Boivin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-018-5386-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2018"
                        "volumen" => "44"
                        "paginaInicial" => "1904"
                        "paginaFinal" => "1913"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30291377"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantifying systemic congestion with point-of-care ultrasound&#58; development of the venous excess ultrasound grading system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Beaubien-Souligny"
                            1 => "P&#46; Rola"
                            2 => "K&#46; Haycock"
                            3 => "J&#46; Bouchard"
                            4 => "Y&#46; Lamarche"
                            5 => "R&#46; Spiegel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13089-020-00163-w"
                      "Revista" => array:3 [
                        "tituloSerie" => "Ultrasound J"
                        "fecha" => "2020"
                        "volumen" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies&#58; the PRISMA-DTA statement"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "the PRISMA-DTA Group"
                          "etal" => true
                          "autores" => array:5 [
                            0 => "M&#46;D&#46;F&#46; McInnes"
                            1 => "D&#46; Moher"
                            2 => "B&#46;D&#46; Thombs"
                            3 => "T&#46;A&#46; McGrath"
                            4 => "P&#46;M&#46; Bossuyt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2017.19163"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2018"
                        "volumen" => "319"
                        "paginaInicial" => "388"
                        "paginaFinal" => "396"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29362800"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analysis of observational studies in epidemiology&#58; a proposal for reporting&#46; Meta-analysis Of Observational Studies in Epidemiology &#40;MOOSE&#41; group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;F&#46; Stroup"
                            1 => "J&#46;A&#46; Berlin"
                            2 => "S&#46;C&#46; Morton"
                            3 => "I&#46; Olkin"
                            4 => "G&#46;D&#46; Williamson"
                            5 => "D&#46; Rennie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/JAMA.283.15.2008"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2000"
                        "volumen" => "283"
                        "paginaInicial" => "2008"
                        "paginaFinal" => "2012"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10789670"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute kidney injury network&#58; report of an initiative to improve outcomes in acute kidney injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;L&#46; Mehta"
                            1 => "J&#46;A&#46; Kellum"
                            2 => "S&#46;V&#46; Shah"
                            3 => "B&#46;A&#46; Molitoris"
                            4 => "C&#46; Ronco"
                            5 => "D&#46;G Warnock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc5713"
                      "Revista" => array:3 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2007"
                        "volumen" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute renal failure &#8211; definition&#44; outcome measures&#44; animal models&#44; fluid therapy and information technology needs&#58; the Second International Consensus Conference of the Acute Dialysis Quality Initiative &#40;ADQI&#41; Group"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Bellomo"
                            1 => "C&#46; Ronco"
                            2 => "J&#46;A&#46; Kellum"
                            3 => "R&#46;L&#46; Mehta"
                            4 => "P&#46; Palevsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc2872"
                      "Revista" => array:3 [
                        "tituloSerie" => "Crit Care &#40;London&#44; England&#41;"
                        "fecha" => "2004"
                        "volumen" => "8"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Meta-analysis in clinical trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "T&#46;G&#46;A&#46; Wells"
                            1 => "B&#46; Shea"
                            2 => "D&#46; O&#8217;Connell"
                            3 => "J&#46; Peterson"
                            4 => "V&#46; Welch"
                            5 => "M&#46; Losos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0197-2456(86)90046-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Control Clin Trials"
                        "fecha" => "1986"
                        "volumen" => "7"
                        "paginaInicial" => "177"
                        "paginaFinal" => "188"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3802833"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Focus on renal blood flow in mechanically ventilated patients with SARS-CoV-2&#58; a prospective pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Fogagnolo"
                            1 => "S&#46; Grasso"
                            2 => "M&#46; Dres"
                            3 => "L&#46; Gesualdo"
                            4 => "F&#46; Murgolo"
                            5 => "E&#46; Morelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10877-020-00633-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Monit Comput"
                        "fecha" => "2021"
                        "volumen" => "36"
                        "paginaInicial" => "161"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33385260"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic accuracy of arterial and venous renal Doppler assessment for acute kidney injury in critically ill patients&#58; a prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Wiersema"
                            1 => "T&#46; Kaufmann"
                            2 => "H&#46;N&#46; van der Veen"
                            3 => "R&#46;J&#46; de Haas"
                            4 => "C&#46;F&#46;M&#46; Franssen"
                            5 => "J&#46; Koeze"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2020.05.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Crit Care"
                        "fecha" => "2020"
                        "volumen" => "59"
                        "paginaInicial" => "57"
                        "paginaFinal" => "62"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32526633"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alterations in portal vein flow and intrarenal venous flow are associated with acute kidney injury after cardiac surgery&#58; a prospective observational cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Beaubien-Souligny"
                            1 => "A&#46; Benkreira"
                            2 => "P&#46; Robillard"
                            3 => "N&#46; Bouabdallaoui"
                            4 => "M&#46; Chass&#233;"
                            5 => "G&#46; Desjardins"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/JAHA.118.009961"
                      "Revista" => array:3 [
                        "tituloSerie" => "J Am Heart Assoc"
                        "fecha" => "2018"
                        "volumen" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The use of venous Doppler to predict adverse kidney events in a general ICU cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Spiegel"
                            1 => "W&#46; Teeter"
                            2 => "S&#46; Sullivan"
                            3 => "K&#46; Tupchong"
                            4 => "N&#46; Mohammed"
                            5 => "M&#46; Sutherland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-020-03330-6"
                      "Revista" => array:3 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2020"
                        "volumen" => "24"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Newcastle-Ottawa Scale &#40;NOS&#41; for assessing the quality of nonrandomised studies in meta-analyses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Wells"
                            1 => "B&#46; Shea"
                            2 => "D&#46; O&#8217;Connell"
                            3 => "J&#46; Peterson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2013"
                        "editorial" => "Ottawa Hospital Research Institute"
                        "editorialLocalizacion" => "Ottawa&#44; ON"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;S&#46; Levey"
                            1 => "J&#46; Coresh"
                            2 => "T&#46; Greene"
                            3 => "L&#46;A&#46; Stevens"
                            4 => "Y&#46;L&#46; Zhang"
                            5 => "S&#46; Hendriksen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7326/0003-4819-145-4-200608150-00004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "2006"
                        "volumen" => "145"
                        "paginaInicial" => "247"
                        "paginaFinal" => "254"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16908915"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of major adverse kidney events within the electronic health record"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;W&#46; Semler"
                            1 => "T&#46;W&#46; Rice"
                            2 => "A&#46;D&#46; Shaw"
                            3 => "E&#46;D&#46; Siew"
                            4 => "W&#46;H&#46; Self"
                            5 => "A&#46;B&#46; Kumar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10916-016-0528-z"
                      "Revista" => array:3 [
                        "tituloSerie" => "J Med Syst"
                        "fecha" => "2016"
                        "volumen" => "40"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute kidney injury"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;A&#46; Kellum"
                            1 => "P&#46; Romagnani"
                            2 => "G&#46; Ashuntantang"
                            3 => "C&#46; Ronco"
                            4 => "A&#46; Zarbock"
                            5 => "H&#46;J&#46; Anders"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41572-021-00284-z"
                      "Revista" => array:3 [
                        "tituloSerie" => "Nat Rev Dis Primers"
                        "fecha" => "2021"
                        "volumen" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Focused ultrasound training for clinicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;L&#46;P&#46; Langlois"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.CCM.0000260625.63077.05"
                      "Revista" => array:4 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2007"
                        "volumen" => "35"
                        "numero" => "Suppl&#46;"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The intrinsic renal compartment syndrome&#58; new perspectives in kidney transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Herrler"
                            1 => "A&#46; Tischer"
                            2 => "A&#46; Meyer"
                            3 => "S&#46; Feiler"
                            4 => "M&#46; Guba"
                            5 => "S&#46; Nowak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/TP.0b013e3181c40aba"
                      "Revista" => array:7 [
                        "tituloSerie" => "Transplantation"
                        "fecha" => "2010"
                        "volumen" => "89"
                        "paginaInicial" => "40"
                        "paginaFinal" => "46"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20061917"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1535610822000599"
                          "estado" => "S300"
                          "issn" => "15356108"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Uncertainty in heterogeneity estimates in meta-analyses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;P&#46;A&#46; Ioannidis"
                            1 => "N&#46;A&#46; Patsopoulos"
                            2 => "E&#46; Evangelou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/BMJ.39343.408449.80"
                      "Revista" => array:4 [
                        "tituloSerie" => "BMJ Br Med J"
                        "fecha" => "2007"
                        "volumen" => "335"
                        "paginaInicial" => "914"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resistive index or color-Doppler semi-quantitative evaluation of renal perfusion by inexperienced physicians&#58; results of a pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Schnell"
                            1 => "M&#46; Reynaud"
                            2 => "M&#46; Venot"
                            3 => "A&#46;L&#46; Le Maho"
                            4 => "M&#46; Dinic"
                            5 => "M&#46; Baulieu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Minerva Anestesiol"
                        "fecha" => "2014"
                        "volumen" => "80"
                        "paginaInicial" => "1273"
                        "paginaFinal" => "1281"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24569358"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/00000043000000S2/v2_202402210544/S2013251423000858/v2_202402210544/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "42660"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/00000043000000S2/v2_202402210544/S2013251423000858/v2_202402210544/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251423000858?idApp=UINPBA000064"
]

Article information

ISSN: 20132514
Original language: English

DOI:10.1016/j.nefroe.2023.05.010

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	8	8	16
2024 October	69	106	175
2024 September	80	73	153
2024 August	88	106	194
2024 July	54	43	97
2024 June	76	77	153
2024 May	89	73	162
2024 April	84	75	159
2024 March	62	59	121
2024 February	68	65	133
2024 January	27	34	61

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter