Early detection of postoperative acute kidney injury by Doppler renal resistive index in cardiac surgery with cardiopulmonary bypass

Abstract

RRI used in the immediate POP after cardiac surgery with CPB enabled prediction of delayed AKI and anticipation of its severity.

The Doppler renal resistive index for early detection of acute kidney injury after hip fracture

“…The RI threshold of 0.71 for predicting AKI after hip fracture surgery is equivalent to the RI threshold in major orthopaedic surgery, 8 in cardiac surgery, 7 and in septic shock. 16 Most cases of AKI occur postoperatively, suggesting that the aetiology of AKI is multifactorial involving preoperative, intraoperative (such as bleeding, fluid management, innate immune responses to trauma and surgery) and postoperative factors.…”

“…2 Indeed, perioperative detection of AKI is difficult as serum creatinine (sCr) concentration or clearance and urine output lack specificity and sensitivity. 7 …”

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

“…Several other preliminary trials also suggest that the resistive index would allow clinicians to distinguish pre-renal (non-organic) from intrarenal (organic) AKI [45][46][47], to predict renal function outcome at days 3 or 5 [43,[48][49][50] and to predict RRT [51]. Thus, these studies suggest that the resistive index could be a tool for assessing renal prognosis with a good sensitivity and specificity [45,[47][48][49][50][51]. Certain studies performed on non-critically ill septic patients (35-91) have small sample sizes, which are mostly monocentric in nature or have poor methodological design [45-47, 49, 50].…”

Renal Relevant Radiology

“…Studies suggest that RI may be a useful tool for predicting AKI, distinguishing ATN (or other parenchymal diseases) from prerenal azotemia, and predicting severity in AKI as summarized in Table 3. Three studies (26)(27)(28) have examined the utility of RI to predict AKI; in these studies, RIs of 0.74, 0.74, and 0.71 were found to be useful cut-points to predict AKI 1-5 days after the RI measurement in patients after cardiac bypass requiring surgery, with septic shock, or in the intensive care unit (ICU) for trauma or sepsis, respectively; patients who did not develop AKI had initial RIs of 0.68, 0.68, and 0.66, respectively. In studies of RI in prerenal azotemia versus intrinsic AKI (29)(30)(31), an RI$0.75 correlated well with the diagnosis of ATN, while prerenal azotemia was typically associated with an RI,0.71.…”