scholarly journals Evaluation of the diagnostic value of the renal resistive index as a marker of the subclinical development of cardiorenal syndrome in MMVD dogs

2021 ◽  
Vol 22 (1) ◽  
pp. 147032032199508
Author(s):  
Barbara Szczepankiewicz ◽  
Urszula Pasławska ◽  
Natalia Siwińska ◽  
Krzysztof Plens ◽  
Robert Pasławski
Keyword(s):  
Resistive Index ◽  
Kidney Injury ◽  
Cardiorenal Syndrome ◽  
Diagnostic Value ◽  
Blood Analysis ◽  
Renal Resistive Index ◽  
Control Group ◽  
Abdominal Ultrasonography ◽  
Non Invasive ◽  
Heart Group

Introduction: Myxomatous mitral valve disease (MMVD) in dogs inevitably causes renal dysfunction. These interactions are known as the cardiorenal syndrome (CRS). The main aims of the study were to evaluate whether renal resistive index (RRI) may be useful as a non-invasive marker in subclinical stage of kidney injury in dogs with MMVD and to compare RRI with SDMA and Cyst C. Methods: Forty-four dogs were divided into two groups: control—15 healthy dogs and the heart group—29 dogs with MMVD (ACVIM class Cc). Study protocol included: anamnesis, clinical examination, electrocardiography, echocardiography, chest radiography, abdominal ultrasonography with measurements of the renal resistive index (RRI), urine, and blood analysis. Results: The RRI in the heart group was significantly higher 0.725 ± 0.035 versus control group 0.665 ± 0.028 ( p < 0.00085). The RRI cut-off point in dogs with stable chronic heart failure (CHF) under 8 years is 0.775, in older 0.64. RRI was similar in MMVD dogs treated with ACE-I + furosemide and dogs treated ACE-I + torasemide + pimobendan + spironolactone. There was no correlation between RRI and SDMA or Cyst C. Conclusion: RRI is more sensitive than creatinine, SDMA and Cyst C to reveal kidney injury in MMVD dogs class Cc younger than 8 years.

scholarly journals Bedside Renal Doppler Ultrasonography and Acute Kidney Injury after TAVR

2020 ◽  
Vol 9 (4) ◽  
pp. 905
Author(s):  
Marilou Peillex ◽  
Benjamin Marchandot ◽  
Sophie Bayer ◽  
Eric Prinz ◽  
Kensuke Matsushita ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Severe Aortic Stenosis ◽  
Resistive Index ◽  
Kidney Injury ◽  
Right Atrial ◽  
Renal Resistive Index ◽  
Serum Cystatin C ◽  
Systemic Hemodynamic ◽  
Dismal Prognosis ◽  
Renal Doppler

Acute kidney injury (AKI) following transcatheter aortic valve replacement (TAVR) is associated with a dismal prognosis. Elevated renal resistive index (RRI), through renal Doppler ultrasound (RDU) evaluation, has been associated with AKI development and increased systemic arterial stiffness. Our pilot study aimed to investigate the performance of Doppler based RRI to predict AKI and outcomes in TAVR patients. From May 2018 to May 2019, 100 patients with severe aortic stenosis were prospectively enrolled for TAVR and concomitant RDU evaluation at our institution (Nouvel Hôpital Civil, Strasbourg University, France). AKI by serum Creatinine (sCr-AKI) was defined according to the VARC-2 definition and AKI by serum Cystatin C (sCyC-AKI) was defined as an sCyC increase of greater than 15% with baseline value. Concomitant RRI measurements as well as renal and systemic hemodynamic parameters were recorded before, one day, and three days after TAVR. It was found that 10% of patients presented with AKIsCr and AKIsCyC. The whole cohort showed higher baseline RRI values (0.76 ± 0.7) compared to normal known and accepted values. AKIsCyC had significant higher post-procedural RRI one day (Day 1) after TAVR (0.83 ± 0.1 vs. 0.77 ± 0.6, CI 95%, p = 0.005). AUC for AKIsCyC was 0.766 and a RRI cut-off value of ≥ 0.795 had the most optimal sensitivity/specificity (80/62%) combination. By univariate Cox analysis, Mehran Risk Score, higher baseline right atrial pressure at baseline >0.8 RRI values one day after TAVR (HR 6.5 (95% CI 1.3–32.9; p = 0.021) but not RRI at baseline were significant predictors of AKIsCyC. Importantly, no significant impact of baseline biological parameters, renal or systemic parameters could be demonstrated. Doppler-based RRI can be helpful for the non-invasive assessment of AKI development after TAVR.

Semiquantitative Power Doppler Ultrasound Score to Predict Acute Kidney Injury in Patients With Sepsis or Cardiac Failure: A Prospective Observational Study

2019 ◽  
Vol 36 (1) ◽  
pp. 115-122 ◽  
Author(s):  
Hai Jun Zhi ◽  
Jing Zhao ◽  
Shen Nie ◽  
Yun Jie Ma ◽  
Xiao Ya Cui ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Doppler Ultrasound ◽  
Cardiac Failure ◽  
Power Doppler ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index ◽  
Power Doppler Ultrasound ◽  
Predictive Values ◽  
Ultrasound Score

Background: Diagnosing acute kidney injury (AKI) stage 3 in critically ill patients may help physicians in making treatment decisions. This diagnosis relies chiefly on urinary output and serum creatinine, which may be of limited value. This study aimed to explore the diagnostic performance of renal resistive index (RRI) and semiquantitative power Doppler ultrasound (PDU) scores in predicting AKI stage 3 in patients with sepsis or cardiac failure. Methods: This study is a prospective observational study that included 83 patients (40 with sepsis and 43 with cardiac failure). Renal resistive index and semiquantitative PDU scores were measured within 6 hours following admission to the intensive care unit. Acute kidney injury was defined according to the criteria set by Kidney Disease Improving Global Outcomes. Results: The predictive values of RRI (area under the curve [AUC] = 0.772, 95% confidence interval [CI] = 0.658-0.886) and PDU score (AUC = 0.780, 95% CI = 0.667-0.892) were similar in all patients. Power Doppler ultrasound score (AUC = 0.910, 95% CI = 0.815-1.000) could effectively predict AKI stage 3 in the cardiac failure subgroup, and the optimal cutoff for this parameter was ≤ 1 (sensitivity = 87.5%, specificity = 92.6%, Youden index = 0.801, accuracy in our population = 90.7%). However, PDU scores (AUC = 0.620, 95% CI = 0.425-0.814) could not predict AKI stage 3 in the sepsis subgroup. The predictive values of RRI for AKI stage 3 in the cardiac failure (AUC = 0.820, 95% CI = 0.666-0.974) and sepsis (AUC = 0.724, 95% CI = 0.538-0.910) subgroups were similar. Conclusions: Power Doppler ultrasound scores could effectively predict AKI stage 3 in patients with cardiac failure but not in patients with sepsis. Renal resistive index is a poor predictor of AKI stage 3 in patients with sepsis or cardiac failure.

scholarly journals Intraoperative renal resistive index threshold as an acute kidney injury biomarker

2020 ◽  
Vol 61 ◽  
pp. 109626 ◽  
Author(s):  
Anne D. Cherry ◽  
Jennifer N. Hauck ◽  
Benjamin Y. Andrew ◽  
Yi-Ju Li ◽  
Jamie R. Privratsky ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index

scholarly journals Comparison of Neutrophil Gelatinase-associated Lipocalin and Renal Resistive Index as Acute Kidney Injury Predictor in Critically Ill Patients at ICU H. Adam Malik Hospital Medan

2021 ◽  
Vol 9 (B) ◽  
pp. 1637-1639
Author(s):  
Muhammad Aldi Rivai Ginting ◽  
Achsanuddin Hanafie ◽  
Bastian Lubis
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index ◽  
Ngal Level ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

BACKGROUND: Acute kidney injury (AKI) is a complication found in critically ill patients. Current consensus explains that diagnosis of AKI based on increased serum creatinine and decreased urine output. Neutrophil gelatinase-associated lipocalin (NGAL) level is increased a few hours after tubular damage occurred and can predict AKI more significantly than serum creatinine. Renal resistive index (RRI) is also a good marker in predicting the early stage of AKI. AIM: This study aimed to compare RRI and NGAL level as marker to predict incidence of AKI in critically ill patients treated in the Intensive Care Unit (ICU) at H. Adam Malik Hospital Medan. METHODS: This was an observational prospective cohort study and conducted in ICU at H. Adam Malik Hospital Medan in April-May 2021. This study had been approved by the Ethics Committee of Faculty of Medicine, Sumatera Utara University and H. Adam Malik Hospital Medan. Inclusion criteria are critical patients aged 18–65 years with 1st and 2nd priority level. Consecutive sampling was used. Resistive Index (RI) measured using USG Doppler by researcher and the results confirmed by ICU supervisors, while urine NGAL level measured within 3 h after ICU admission. Plasma urea and creatinine level measured after 24h after ICU admission. RESULTS: A total of 40 samples were collected; percentage of men and women are 66–35%, respectively (p = 0.001). There was a significant difference RI between AKI-group and non-AKI group (0.719 ± 0.060 and 0.060 ± 0.077, respectively) (p = 0.001). RI has a sensitivity of 71%, specificity of 84%, and accuracy of 87% in predicting occurrence of AKI with AUROC = 0.873. Meanwhile, NGAL has a sensitivity, specificity, and accuracy (66%, 89%, 78%, respectively) in early prediction of AKI incidence in critically ill patients. CONCLUSION: RI value was higher in AKI group than non-AKI group. RRI has better sensitivity than NGAL in predicting incidence of AKI.

scholarly journals Goal-directed hemodynamic therapy in patients with colorectal cancer undergoing laparoscopic surgery

2020 ◽  
Vol 16 (1) ◽  
pp. 29-36
Author(s):  
V. A. Panafidina ◽  
I. V. Shlyk
Keyword(s):  
Colorectal Cancer ◽  
Acute Kidney Injury ◽  
Cardiac Output ◽  
Perfusion Pressure ◽  
Kidney Injury ◽  
Control Group ◽  
Hemodynamic Management ◽  
Goal Directed Therapy ◽  
Non Invasive ◽  
Hemodynamic Therapy

Introduction. The conductance of goal-directed hemodynamic therapy is controversial due to the difficulty in its implementation in routine practice despite the significant number of studies and meta-analyses.Objective. To estimate the efficacy of a modified algorithm of goal-directed hemodynamic management in patients with colorectal cancer who undergo laparoscopic surgery based on non-invasive monitoring of cardiac output.Subjects and methods. A single-centered, randomized trial was conducted. The control group included 75 patients, while the goal-directed therapy (GDT) group included 72 patients. In the control group, hemodynamic management was based on mean arterial pressure and intraabdominal perfusion pressure. In addition, results of fluid responsiveness tests were considered in the GDT group. The suggested protocol efficacy was evaluated on the basis of frequency of critical incidents, shifts in acid-base balance and lactate concentration, infusion volume, vasopressor doses, the incidence of acute kidney injury, and other complications.Results. After anesthesia induction and according to the results of a modified, passive leg raising test, 67.1% of patients were considered responders and received 1250 (1000; 1500) ml of balanced crystalloids before carboxyperitoneum. The infusion differentiation test of hypotension cause was performed in 47 patients of the GDT group, 37% were considered responders, and others received vasopressors and/or inotropes. The use of the GDT protocol led to a decrease in total infusion volume and vasopressor doses. A lower frequency of critical incidents was recorded when the GDT protocol was used. In the GDT group, there were no signs of ischemia and increased frequency of complications (including acute kidney injury).Conclusions. Testing of fluid responsiveness and non-invasive cardiac output monitoring allows for the correction of hemodynamics during surgery. Goal-directed therapy in the intraoperative period allows different approaches to maintaining systemic and intraabdominal perfusion pressure, thus decreasing the total volume of infusion without increasing hypoperfusion risk.

Plasma cystatin C versus renal resistive index as early predictors of acute kidney injury in critically ill neonates

2020 ◽  
Vol 16 (2) ◽  
pp. 206.e1-206.e8
Author(s):  
Akram E. El-sadek ◽  
Mohamed A. El-Gamasy ◽  
Eman G. Behiry ◽  
Ahmed A. Torky ◽  
Mohamed A. Fathy
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Cystatin C ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index ◽  
Early Predictors ◽  
Critically Ill Neonates
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