Factors associated with renal Doppler resistive index in critically ill patients: a prospective cohort study

Raphael A G Oliveira^{1

2}, Pedro V Mendes^{3

2}, Marcelo Park³, Leandro U Taniguchi^{4

5}

Affiliations

¹ Surgical Emergencies and Trauma ICU, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Enéas de Carvalho Aguiar 255, São Paulo, SP, Postal Code: 05403-000, Brazil.
² Hospital Sirio Libanes, Rua Daher Cutait 69, São Paulo, SP, Postal Code: 01308-060, Brazil.
³ Emergency Medicine Discipline, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Enéas de Carvalho Aguiar 255 Sala 5023, São Paulo, SP, Postal Code: 05403-000, Brazil.
⁴ Emergency Medicine Discipline, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Enéas de Carvalho Aguiar 255 Sala 5023, São Paulo, SP, Postal Code: 05403-000, Brazil. leandro.taniguchi@gmail.com.
⁵ Hospital Sirio Libanes, Rua Daher Cutait 69, São Paulo, SP, Postal Code: 01308-060, Brazil. leandro.taniguchi@gmail.com.

PMID: 30706172
PMCID: PMC6355884
DOI: 10.1186/s13613-019-0500-4

Factors associated with renal Doppler resistive index in critically ill patients: a prospective cohort study

Raphael A G Oliveira et al. Ann Intensive Care. 2019.

. 2019 Jan 31;9(1):23.

doi: 10.1186/s13613-019-0500-4.

Authors

Raphael A G Oliveira^{1

2}, Pedro V Mendes^{3

2}, Marcelo Park³, Leandro U Taniguchi^{4

5}

Affiliations

¹ Surgical Emergencies and Trauma ICU, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Enéas de Carvalho Aguiar 255, São Paulo, SP, Postal Code: 05403-000, Brazil.
² Hospital Sirio Libanes, Rua Daher Cutait 69, São Paulo, SP, Postal Code: 01308-060, Brazil.
³ Emergency Medicine Discipline, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Enéas de Carvalho Aguiar 255 Sala 5023, São Paulo, SP, Postal Code: 05403-000, Brazil.
⁴ Emergency Medicine Discipline, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av Enéas de Carvalho Aguiar 255 Sala 5023, São Paulo, SP, Postal Code: 05403-000, Brazil. leandro.taniguchi@gmail.com.
⁵ Hospital Sirio Libanes, Rua Daher Cutait 69, São Paulo, SP, Postal Code: 01308-060, Brazil. leandro.taniguchi@gmail.com.

PMID: 30706172
PMCID: PMC6355884
DOI: 10.1186/s13613-019-0500-4

Abstract

Background: The renal Doppler resistive index (renal RI) is a noninvasive tool that has been used to assess renal perfusion in the intensive care unit (ICU) setting. However, many parameters have been described as influential on the values of renal RI. Therefore, we proposed this study to evaluate the variables that could impact renal RI in critically ill patients.

Methods: A prospective observational study was performed in a 14-bed medical-surgical adult ICU. All consecutive patients admitted to the ICU during the study period were evaluated for eligibility. Renal RI was performed daily until the third day after ICU admission, death, or renal replacement therapy (RRT) requirement. Clinical and blood test data were collected throughout this period. Acute kidney injury (AKI) reversibility was categorized as transient (normalization of renal function within 3 days of AKI onset) or persistent (non-resolution of AKI within 3 days of onset or need for RRT). A linear mixed model was applied to evaluate the factors that could influence renal RI.

Results: Eighty-three consecutive patients were included. Of these, 65% were male and 50.6% were medical admissions. Mean SAPS 3 was 47 ± 16. Renal RI was significantly different between no-AKI (0.64 ± 0.06), transient AKI (0.64 ± 0.07), and persistent AKI groups (0.70 ± 0.08, p < 0.01). Variables associated with renal RI variations were mean arterial pressure, lactate, age, and persistent AKI (p < 0.05). No association between serum chloride and renal RI was observed (p = 0.868).

Conclusions: Mean arterial pressure, lactate, age, and type of AKI might influence renal RI in critically ill patients.

Keywords: Acute kidney injury; Chloride; Critical care; Doppler ultrasonography; Intensive care unit; Renal resistive index.

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Figures

**Fig. 1**
Flowchart of patients eligible and included in this study

**Fig. 2**
Mean renal RI values according to acute kidney injury category. *AKI* acute kidney injury, RI renal resistive index. Error bars represent ± 1 standard error of the mean

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Factors associated with renal Doppler resistive index in critically ill patients: a prospective cohort study

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Factors associated with renal Doppler resistive index in critically ill patients: a prospective cohort study

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