Doppler monitoring of renal hemodynamics: why the best is yet to come

Duranteau, Jacques; Deruddre, Stéphane; Vigué, Bernard; Chemla, Denis

doi:10.1007/s00134-008-1107-7

Cited by 23 publications

(11 citation statements)

References 12 publications

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“…This contradictory set of results could be explained by two limitations associated with this technique. The first is the significance of the resistive index values and variations, which remains unclear because the relationship between this parameter and renal vascular resistances seems to be poor, perhaps due to a large number of additional factors implicated in AKI [38,39,[53][54][55][56]. Indeed, experiments performed on models of ex vivo kidneys have confirmed a major role for vascular compliance (modification in vascular diameter following changes in pressure) or pulse pressure as a determinant of the resistive index [54][55][56].…”

Section: (Experts Opinion) Strong Agreementmentioning

confidence: 99%

“…Rationale: Measurement of renal velocity by Doppler ultrasound is a non-invasive and rapid surrogate method that allows the instantaneous assessment of parenchymal renal perfusion [38,39]. Because of its easily accurate and repeatable measurements, this approach supposedly allows the assessment of modifications of RBF in response to therapeutic management.…”

Section: (Grade 2−) Strong Agreementmentioning

confidence: 99%

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Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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Acute kidney injury (AKI) is a syndrome that has progressed a great deal over the last 20 years. The decrease in urine output and the increase in classical renal biomarkers, such as blood urea nitrogen and serum creatinine, have largely been used as surrogate markers for decreased glomerular filtration rate (GFR), which defines AKI. However, using such markers of GFR as criteria for diagnosing AKI has several limits including the difficult diagnosis of non-organic AKI, also called "functional renal insufficiency" or "pre-renal insufficiency". This situation is characterized by an oliguria and an increase in creatininemia as a consequence of a reduction in renal blood flow related to systemic haemodynamic abnormalities. In this situation, "renal insufficiency" seems rather inappropriate as kidney function is not impaired. On the contrary, the kidney delivers an appropriate response aiming to recover optimal systemic physiological haemodynamic conditions. Considering the kidney as insufficient is erroneous because this suggests that it does not work correctly, whereas the opposite is occurring, because the kidney is healthy even in a threatening situation. With current definitions of AKI, normalization of volaemia is needed before defining AKI in order to avoid this pitfall.

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Section: (Experts Opinion) Strong Agreementmentioning

confidence: 99%

Section: (Grade 2−) Strong Agreementmentioning

confidence: 99%

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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“…Owing to the repeatability of this technique, any temporal alterations within the renal arteries due to treatment protocols can be easily followed by DU indices, including peak systolic velocity (PSV), pulsatility index (PI), and resistive index (RI) 2,3. Alterations in these parameters have been noted in a range of conditions affecting the kidney, such as acute variations in renal vascular resistance (eg, renal artery stenosis) and renal damage in multiple-organ dysfunction syndrome 4,5.…”

Section: Introductionmentioning

confidence: 99%

Are Doppler ultrasonography parameters symmetric between the right and left kidney?

Ansarin¹,

Bavil²,

Ghabili³

et al. 2010

IJGM

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Background:Among numerous modalities applied for evaluation of kidney diseases, Doppler ultrasonography (DU) provides information about the hemodynamic status of the kidneys. Meanwhile, the variability in DU parameters of the right and left kidney is a matter of controversy. The aim of this study was to determine whether any difference exists between the DU indices of the right and left kidney.Methods:Retrospectively, we collected DU findings of 25 healthy potential renal transplant donors. All donors underwent renal DU and multidetector computed tomographic angiography before donor nephrectomy. DU indices, including peak systolic volume (PSV), resistive index (RI), pulsatility index (PI), end-diastolic volume (EDV), and acceleration time (AT), were recorded.Results:The median age of the donors was 27 (range 23–39) years. The median PSV, RI, EDV, and AT for the right kidney were 29 cm/sec, 0.59, 10.9 cm/sec, and 50 msec, respectively. For the left kidney, the median PSV, RI, EDV, and AT were, respectively, 26.8 cm/sec, 0.60, 10.6 cm/sec, and 43 msec. Among the DU indices, median PI of the right kidney was significantly different from that of the left kidney (1.02 versus 0.95, P = 0.01).Conclusion:In conclusion, the present study revealed that right kidney DU indices, except for PI, may not differ from those of the left kidney.

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“…Doppler-based renal resistive index (RI) measurement is rapid, noninvasive, and repeatable and may therefore hold promise for monitoring renal function or renal perfusion in critically ill patients (5). A growing body of evidence suggests that Doppler-based renal RI may be useful in critically ill patients.…”

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confidence: 99%

“…A growing body of evidence suggests that Doppler-based renal RI may be useful in critically ill patients. In addition, repeated Doppler-based RI measurements may help in monitoring renal perftision during gradual norepinephrine dose adjustment in patients receiving low-dose dopamine infiisions or exhibiting hypoxemia (5,(11)(12)(13). In addition, repeated Doppler-based RI measurements may help in monitoring renal perftision during gradual norepinephrine dose adjustment in patients receiving low-dose dopamine infiisions or exhibiting hypoxemia (5,(11)(12)(13).…”

mentioning

confidence: 99%