The renal vascular resistive index as a predictor of acute kidney injury in children of the first year of life in congenital heart surgery with cardiopulmonary bypass
https://doi.org/10.24884/2078-5658-2023-20-5-26-32
Abstract
The objective was to evaluate the renal vascular resistive index as a predictor of acute kidney injury in children of the first year of life in congenital heart surgery with cardiopulmonary bypass.
Materials and methods. A single-center retrospective study included 150 patients with congenital heart disease (CHD), whose renal vascular resistive index (RVRI) was assessed at the stages of surgical interventions (before surgery, 6 hours after the end of cardiopulmonary bypass (CPB) and the 1st day after surgery). Acute kidney injury (AKI) was diagnosed according to the KDIGO criteria. To achieve comparability of the obtained groups, pseudo-randomization was performed. After compensating for the uneven distribution of cofounders, groups of patients comparable in number were obtained (n= 52 in both groups).
Results. The renal vascular resistive index at the stages of surgical intervention did not differ among patients with and without acute kidney injury. The baseline of creatinine was higher in the group without AKI, however, starting from the 1st postoperative day, it prevailed in the group with AKI. The chances of developing AKI in male patients were 74% lower.
Conclusion. The absence of a predictive ability of the renal vascular resistive index in acute kidney injury in children aged 1 month to 1 year with congenital heart disease operated with cardiopulmonary bypass was demonstrated.
About the Authors
S. A. Sergeev
Meshalkin National Medical Research Center
Russian Federation
Russian Federation
Sergeev Stanislav A. - Head of the Department of Anesthesiology and Intensive Care for Children with Resuscitation and Intensive Care Units
15, Rechkunovskaya str., Novosibirsk, 630055
V. V. Lomivorotov
Meshalkin National Medical Research Center
Russian Federation
Russian Federation
Lomivorotov Vladimir V. - Dr. of Sci. (Med.), Professor, Corresponding member of RAS, Head of the Center of Anesthesiology and Intensive Care
15, Rechkunovskaya str., Novosibirsk, 630055
References
1. Khmelevskaya I.G., Bets O.G., Arkhipova A.G. Risk factors and the like-lihood of acute renal failure in children with congenital malformations of the urinary system. Lechaschi Vrach, 2020, no. 9, pp. 7–10. (In Russ.) Doi: 10.26295/OS.2020.69.90.001.
2. Chugunova O.L., Ivanov D.O., Kozlova E.M. et al. Acute renal injury in newborns (clinical practice guidelines project). Neonatology, 2019, no. 4, pp. 68.
3. Aboyans V., Tanguy B., Desormais I. et al. Prevalence of renal artery disease and its prognostic significance in patients undergoing coronary bypass grafting // Am J Cardiol. – 2014. – Vol. 114, № 7. – P. 1029–1034. Doi: 10.1016/j.amjcard.2014.07.011.
4. Andriani G., Persico A., Tursini S. et al. The renal-resistive index from the last 3 months of pregnancy to 6 months old // BJU Int. – 2001. – Vol. 87, № 6. – P. 562–564. Doi: 10.1046/j.1464-410x.2001.00085.x.
5. Blinder J. J., Goldstein S. L., Lee V. V. et al. Congenital heart surgery in infants: effects of acute kidney injury on outcomes // J Thorac Cardiovasc Surg. – 2012. – Vol. 143, № 2. – P. 368–74. Doi: 10.1016/j.jtcvs.2011.06.021.
6. Bude R. O., DiPietro M. A., Platt J. F. et al. Age dependency of the renal resistive index in healthy children // Radiology. – 1992. – Vol. 184, № 2. – P. 469–473. Doi: 10.1148/radiology.184.2.1620850.
7. Darmon M., Schortgen F., Vargas F. et al. Diagnostic accuracy of Doppler renal resistive index for reversibility of acute kidney injury in critically ill patients // Intensive Care Med. – 2011. – Vol. 37, № 1. – P. 68–76. Doi: 10.1007/s00134-010-2050-y.
8. El-Sadek A. E., El-Gamasy M. A., Behiry E. G. et al. Plasma cystatin C versus renal resistive index as early predictors of acute kidney injury in critically ill neonates // J Pediatr Urol. – 2020. – Vol. 16, № 2. – P. 206.e1–206.e8. Doi: 10.1016/j.jpurol.2019.12.001.
9. Gaies M. G., Gurney J. G., Yen A. H. et al. Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass // Pediatr Crit Care Med. – 2010. – Vol. 11, № 2. – P. 234–238. Doi: 10.1097/PCC.0b013e3181b806fc.
10. Hertzberg D., Ceder S. L., Sartipy U. et al. Preoperative renal resistive index predicts risk of acute kidney injury in patients undergoing cardiac surgery // J Cardiothorac Vasc Anesth. – 2017. – Vol. 31, № 3. – P. 847–852. Doi: 10.1053/j.jvca.2016.10.006.
11. Jenkins K. J., Gauvreau K. Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenital Heart Surgery (RACHS-1) method // J Thorac Cardiovasc Surg. – 2002. – Vol. 124, № 1. – P. 97–104. Doi: 10.1067/mtc.2002.122311.
12. Kellum J. A., Lameire N., Aspelin P. et al. KDIGO clinical practice guideline for acute kidney injury // Kidney International Supplements. –2012. – Vol. 2, № 1. – P. 1–138.
13. Keogan M. T., Kliewer M. A., Hertzberg B. S. et al. Renal resistive indexes: variability in Doppler US measurement in a healthy population // Radiology. – 1996. – Vol. 199, № 1. – P. 165–169. Doi: 10.1148/radiology.199.1.8633141.
14. Kim S. H., Kim W. H., Choi B. I. et al. Duplex Doppler US in patients with medical renal disease: resistive index vs serum creatinine level // Clin Radiol. – 1992. – Vol. 45, № 2. – P. 85–87. Doi: 10.1016/s0009-9260(05)80060-1.
15. Lameire N., Hoste E. Reflections on the definition, classification, and diagnostic evaluation of acute renal failure // Curr Opin Crit Care. – 2004. – Vol. 10, № 6. – P. 468–475. Doi: 10.1097/01.ccx.0000144939.24897.71.
16. Lameire N., Van Biesen W., Vanholder R. Acute renal failure // Lancet. – 2005. – Vol. 365, № 9457. – P. 417–430. Doi: 10.1016/S0140-6736(05)17831-3.
17. Lerolle N., Guérot E., Faisy C. et al. Renal failure in septic shock: predictive value of Doppler-based renal arterial resistive index // Intensive Care Med. – 2006. – Vol. 32, № 10. – P. 1553–1559. Doi: 10.1007/s00134-006-0360-x.
18. Li S., Krawczeski C. D., Zappitelli M. et al. TRIBE-AKI Consortium. Incidence, risk factors, and outcomes of acute kidney injury after pediatric cardiac surgery: a prospective multicenter study // Crit Care Med. – 2011. – Vol. 39, № 6. – P. 1493–1499. Doi: 10.1097/CCM.0b013e31821201d3.
19. Marty P., Szatjnic S., Ferre F. et al. Doppler renal resistive index for early detection of acute kidney injury after major orthopaedic surgery: a prospective observational study // Eur J Anaesthesiol. – 2015. – Vol. 32, № 1. – P. 37–43. Doi: 10.1097/EJA.0000000000000120.
20. Haitsma Mulier J. L. G., Rozemeijer S., Röttgering J. G. et al. Renal resistive index as an early predictor and discriminator of acute kidney injury in critically ill patients; A prospective observational cohort study // PLoS One. – Vol. 13, № 6. – P. e0197967. Doi: 10.1371/journal.pone.0197967.
21. Ninet S., Schnell D., Dewitte A. et al. Doppler-based renal resistive index for prediction of renal dysfunction reversibility: A systematic review and meta-analysis // J Crit Care. – 2015. – Vol. 30, № 3. – P. 629–635. Doi: 10.1016/j.jcrc.2015.02.008.
22. Park M., Coca S. G., Nigwekar S. U. et al. Prevention and treatment of acute kidney injury in patients undergoing cardiac surgery: a systematic review // Am J Nephrol. – 2010. – Vol. 31, № 5. – P. 408–418. Doi: 10.1159/000296277.
23. Pedersen K. R., Povlsen J. V., Christensen S. et al. Risk factors for acute renal failure requiring dialysis after surgery for congenital heart disease in children // Acta Anaesthesiol Scand. – 2007. – Vol. 51, № 10. – P. 1344–1349. Doi: 10.1111/j.1399-6576.2007.01379.x.
24. Platt J. F. Duplex Doppler evaluation of native kidney dysfunction: obstructive and nonobstructive disease // AJR Am J Roentgenol. – 1992. – Vol. 158, № 5. – P. 1035–1042. Doi: 10.2214/ajr.158.5.1566663.
25. Platt J. F., Ellis J. H., Rubin J. M. Examination of native kidneys with duplex Doppler ultrasound // Semin Ultrasound CT MR. – 1991. – Vol. 12, № 4. – P. 308–318.
26. Platt J. F., Rubin J. M., Ellis J. H. et al. Duplex Doppler US of the kidney: differentiation of obstructive from nonobstructive dilatation // Radiology. – 1989. – Vol. 171, № 2. – P. 515–517. Doi: 10.1148/radiology.171.2.2649925.
27. Schnell D., Deruddre S., Harrois A. et al. Renal resistive index better predicts the occurrence of acute kidney injury than cystatin C // Shock. – 2012. – Vol. 38, № 6. – P. 592–597. Doi: 10.1097/SHK.0b013e318271a39c.
28. Shaw A., Swaminathan M., Stafford-Smith M. Cardiac surgery-associated acute kidney injury: putting together the pieces of the puzzle // Nephron Physiol. – 2008. – Vol. 109, № 4. – P. 55–60. Doi: 10.1159/000142937.
29. Sutherland S. M., Ji J., Sheikhi F. H. et al. AKI in hospitalized children: epidemiology and clinical associations in a national cohort // Clin J Am Soc Nephrol. – 2013. – Vol. 8, № 10. – P. 1661–1669. Doi: 10.2215/CJN.00270113.
30. Tublin M. E., Bude R. O., Platt J. F. Review. The resistive index in renal Doppler sonography: where do we stand? // AJR Am J Roentgenol. – 2003. – Vol. 180, № 4. – P. 885–892. Doi: 10.2214/ajr.180.4.1800885.
31. Wu H. B., Qin H., Ma W. G. et al. Can renal resistive index predict acute kidney injury after acute type a aortic dissection repair? // Ann Thorac Surg. – 2017. – Vol. 104, № 5. – P. 1583–1589. Doi: 10.1016/j.athoracsur.2017.03.057.
Review
For citations:
Sergeev S.A., Lomivorotov V.V. The renal vascular resistive index as a predictor of acute kidney injury in children of the first year of life in congenital heart surgery with cardiopulmonary bypass. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2023;20(5):26-32. (In Russ.) https://doi.org/10.24884/2078-5658-2023-20-5-26-32
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