Role of direct intraoperative ultrasound-guided renal resistive index and its association with postoperative acute kidney injury in patients undergoing abdominal vascular surgeries: A prospective cohort study
Sachin S. P. Bhardwaj, Tanvir Samra, Nitika Goel, Ajay Savlania, Harish Bhujade, Ganesh K. MunirathinamABSTRACT
Background and Aims:
Acute kidney injury (AKI) is a major complication following abdominal vascular surgery, and current diagnostic markers often detect injury only after significant renal damage has occurred. Doppler-derived renal resistive index (RRI) is a promising real-time marker of renal perfusion. This study evaluated direct intraoperative ultrasound (DIOUS)-guided RRI measurement for assessing postoperative AKI in open abdominal vascular surgery.
Methods:
In this prospective study, 40 adults undergoing open abdominal vascular procedures were enroled. RRI was measured at four timepoints: preoperatively; intraoperatively, 30 minutes after aortic declamping, using DIOUS; and postoperatively at 12 and 24 hours using transabdominal Doppler ultrasonography. AKI was defined using Kidney Disease: Improving Global Outcomes creatinine-based criteria.
Results:
Postoperative AKI developed in 50% of patients. Mean DIOUS-guided RRI measured 30 minutes after declamping was higher in patients who developed AKI than in those who did not (0.74 ± 0.05 vs. 0.69 ± 0.04;
Conclusion:
DIOUS-guided RRI measurement is a feasible method for real-time assessment of renal haemodynamics during open abdominal vascular surgery. The association between intraoperative RRI and postoperative AKI suggests this technique may complement perioperative renal risk assessment and support early kidney-protective interventions, pending validation in larger studies.