ArticleShock (Augusta, Ga.)2019
Renal Resistive Index: Response to Shock and its Determinants in Critically Ill Patients.
Article in Shock (Augusta, Ga.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 40 citations in OpenAlex.
- Effects of changes in position, positive end-expiratory pressure and mean arterial pressure on renal, portal and hepatic Doppler ultrasound perfusion indices: a randomized crossover study in cardiac surgery patients.Journal of clinical monitoring and computing · 2022Trial
- Diagnostic accuracy of doppler-derived renal ultrasound parameters for predicting acute kidney injury after cardiac surgery: a systematic review and meta-analysis.Clinical and experimental nephrology · 2026Article
- Impact of Parathyroidectomy on Vascular Stiffness: Exploring Pulse Wave Velocity and Renal Resistive Index.The Journal of clinical endocrinology and metabolism · 2026Article
- Diagnostic Significance of Renal Artery Resistive Index (RRI), Caudal Vena Cava Diameter (CVC), and Aorta (Ao) in Dogs with Hypovolemia.Veterinary sciences · 2026Article
- The significance of joint evaluation of gastrointestinal ultrasound results and renal artery resistance index for assessing intestinal-renal syndrome in sepsis patients: a retrospective study.Quantitative imaging in medicine and surgery · 2025Article
- The Usefulness of Peripheral and Organ Perfusion Monitoring in Predicting Mortality in Patients with Severe SARS-CoV-2.Biomedicines · 2025Article
- Renal perfusion pressure: role and implications in critical illness.Annals of intensive care · 2025Review
- Impact of positive end-expiratory pressure on renal resistive index in mechanical ventilated patients.Journal of clinical monitoring and computing · 2024Article
- Renal and Genitourinary Ultrasound Evaluation in Emergency and Critical Care: An Overview.Healthcare (Basel, Switzerland) · 2024Review
- Influence of arterial blood gases on the renal arterial resistive index in intensive care unit.Journal of translational medicine · 2023Observational
- The clinical significance of renal resistance index (RRI) and renal oxygen saturation (RrSO2) in critically ill children with AKI: a prospective cohort study.BMC pediatrics · 2023Article
- Renal toxicity and biokinetics models after repeated uranium instillation.Scientific reports · 2023Article
- Ultrasound Doppler Flow Parameters Are Independently Associated with Renal Cortex Contrast-Enhanced Multidetector Computed Tomography Perfusion and Kidney Function.Journal of clinical medicine · 2023Article
- Renal hemodynamic evaluation protocol based on the pathophysiological mechanism of acute kidney injury: Critical Care UltraSound Guided-ARenal failure · 2023Review
- Renal Protection and Hemodynamic Improvement by ImpellaJournal of clinical medicine · 2022Article
- Monitoring of renal perfusion.Intensive care medicine · 2022Article
- Shock Resuscitation - the Necessity and Priority of Renal Blood Perfusion Assessment.Aging and disease · 2022Article
- Intrarenal Doppler approaches in hemodynamics: A major application in critical care.Frontiers in physiology · 2022Review
- Impact of microaxillar mechanical left ventricular support on renal resistive index in patients with cardiogenic shock after myocardial infarction: a pilot trial to predict renal organ dysfunction in cardiogenic shock.European heart journal. Acute cardiovascular care · 2020Article
- [Diagnosing acute organ ischemia : A practical guide for the emergency and intensive care physician].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionShock is characterized by micro- and macrovascular flow impairment contributing to acute kidney injury (AKI). Routine monitoring of the circulation regards the macrocirculation but not the renal circulation which can be assessed with Doppler ultrasound as renal resistive index (RRI). RRI reflects resistance to flow. High RRI predicts persistent AKI. Study aims were to determine whether RRI is elevated in shock and to identify determinants of RRI. MATERIALS AND
methodsThis prospective observational cohort study included two cohorts of patients, with and without shock less than 24-h after intensive care admission. Apart from routine monitoring, three study measurements were performed simultaneously: RRI, sublingual microcirculation, and bioelectral impedance analysis.
resultsA total of 92 patients were included (40 shock, 52 nonshock), median age was 69 [60-76] vs. 67 [59-76], P = 0.541; APACHE III was 87 [65-119] vs. 57 [45-69], P < 0.001. Shock patients had higher RRI than patients without shock (0.751 [0.692-0.788] vs. 0.654 [0.610-0.686], P < 0.001). Overall, high age, APACHE III score, lactate, vasopressor support, pulse pressure index (PPI), central venous pressure (CVP), fluid balance, and low preadmission estimated glomerular filtration rate, mean arterial pressure (MAP), creatinine clearance, and reactance/m were associated with high RRI at univariable regression (P < 0.01). Microcirculatory markers were not. At multivariable regression, vasopressor support, CVP, PPI and MAP, reactance/m, and preadmission eGFR were independent determinants of RRI (n = 92, adj. R = 0.587).
conclusionsPatients with shock have a higher RRI than patients without shock. Independent determinants of high RRI were pressure indices of the systemic circulation, low membrane capacitance, and preadmission renal dysfunction. Markers of the sublingual microcirculation were not.
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