ArticleThe Annals of thoracic surgery2018
The Association of Aortic Valve Pathology With Renal Resistive Index as a Kidney Injury Biomarker.
Article in The Annals of thoracic surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed, 17 citations in OpenAlex.
- Intrarenal Doppler approaches in hemodynamics: A major application in critical care.Frontiers in physiology · 2022Review
- Intraoperative renal resistive index threshold as an acute kidney injury biomarker.Journal of clinical anesthesia · 2020Article
- Renal intraparenchymal resistive index: the ultrasonographic answer to many clinical questions.Journal of nephrology · 2019Review
- Biomarkers for early detection of cardiac surgery-associated acute kidney injury.Journal of thoracic disease · 2018Article
- Renal resistive index as a biomarker for acute kidney injury in aortic valve surgery.Journal of thoracic disease · 2018Article
- Intraoperative Renal Resistive Index as an Acute Kidney Injury Biomarker: Development and Validation of an Automated Analysis Algorithm.Journal of cardiothoracic and vascular anesthesia · 2018Article
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10 authors at 1 institution in 1 country.
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Abstract
backgroundAcute kidney injury (AKI) is a common serious complication after cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (insufficiency and/or stenosis) and RRI is unknown. This study aimed to investigate RRI variability related to aortic valve pathology.
methodsIn a retrospective review of cardiac surgery patients, RRI and aortic valve pathology were assessed prior to cardiopulmonary bypass using transesophageal echocardiography. Aortic valve status was categorized into four subgroups: normal (insufficiency and stenosis, none/trace/mild), insufficiency (insufficiency, moderate/severe; stenosis, none/trace/mild), combined insufficiency/stenosis (insufficiency and stenosis, moderate/severe), or stenosis (insufficiency, none/trace/mild; stenosis, moderate/severe). RRI and time-matched hemodynamic and Doppler measurements were compared among subgroups.
resultsOf 175 patients, 60 had aortic valve pathology (16 insufficiency, 18 insufficiency/stenosis, 26 stenosis). Compared with the normal subgroup, patients with aortic insufficiency had lower diastolic blood pressure and trough renal Doppler velocities, and higher RRI (0.77 versus 0.69; p < 0.001); patients with combined insufficiency/stenosis also had higher RRI (0.72 versus 0.69, p = 0.042).
conclusionsPatients with aortic insufficiency and combined insufficiency/stenosis had higher median RRI values compared with normal patients. For these individuals, diastolic flow differences related to aortic insufficiency may explain why their presurgery RRI values often exceeded postoperative thresholds typically associated with AKI. Strategies to account for the potentially confounding effects of aortic insufficiency on renal flow patterns, independent of renal injury, may add to the value of RRI as an early AKI biomarker.
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