دورية أكاديمية
أعرض في EDS

Intraoperative renal resistive index threshold as an acute kidney injury biomarker.

التفاصيل البيبلوغرافية
العنوان: Intraoperative renal resistive index threshold as an acute kidney injury biomarker.
المؤلفون: Cherry AD; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: anne.cherry@duke.edu., Hauck JN; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: jennifer.hauck@duke.edu., Andrew BY; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: benjamin.andrew@duke.edu., Li YJ; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: yiju.li@duke.edu., Privratsky JR; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: jamie.privratsky@duke.edu., Kartha LD; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA; MetroHealth Hospital, Dept. of Internal Medicine, 2500 MetroHealth Drive, Cleveland, OH 44109, USA., Nicoara A; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: alina.nicoara@duke.edu., Thompson A; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: annemarie.thompson@duke.edu., Mathew JP; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: joseph.mathew@duke.edu., Stafford-Smith M; Duke University Medical Center, Department of Anesthesiology, 2301 Erwin Road, Durham, NC 27710, USA. Electronic address: mark.staffordsmit@dm.duke.edu.
المصدر: Journal of clinical anesthesia [J Clin Anesth] 2020 May; Vol. 61, pp. 109626. Date of Electronic Publication: 2019 Nov 04.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 8812166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4529 (Electronic) Linking ISSN: 09528180 NLM ISO Abbreviation: J Clin Anesth Subsets: MEDLINE
أسماء مطبوعة: Publication: <2008->: New York : Elsevier
Original Publication: [Stoneham, MA] : Butterworths, [c1988-
مواضيع طبية MeSH: Acute Kidney Injury*/diagnosis , Acute Kidney Injury*/etiology , Cardiac Surgical Procedures*/adverse effects, Adult ; Biomarkers ; Humans ; Kidney/diagnostic imaging ; Retrospective Studies
مستخلص: Study Objective: The lag in creatinine-mediated diagnosis of cardiac surgery-associated acute kidney injury (AKI) may be impeding the development of renoprotection therapies. Postoperative renal resistive index (RRI) measured by transabdominal Doppler ultrasound is a promising early AKI biomarker. RRI measured intraoperatively by transesophageal echocardiography (TEE) is available even earlier but is less evaluated. Therefore, we conducted an assessment of intraoperative RRI as an AKI biomarker using previously reported post-renal insult thresholds.
Design: Retrospective convenience sample.
Setting: Intraoperative.
Patients: 180 adult cardiac surgical patients between July 2013 and July 2014.
Intervention: None.
Measurements: Pre- and post-cardiopulmonary bypass (CPB) RRI thresholds, measured using intraoperative TEE, exceeding 0.74 or 0.79 were used to evaluate for an association with KDIGO AKI risk using the Chi-square test. Other consensus AKI criteria (AKIN, RIFLE) were similarly evaluated. Additional t-test analyses examined the relationship of pre- and pre-to-post (delta) CPB RRI with AKI.
Main Results: Post-CPB RRI for 99 patients included 36 and 23 with values exceeding 0.74 and 0.79, respectively. Analyses confirmed associations of both RRI thresholds with all consensus AKI definitions (0.74; KDIGO: p = 0.05, AKIN: p = 0.03, RIFLE: p = 0.03, 0.79; KDIGO: p = 0.002, AKIN: p = 0.001, RIFLE: p = 0.004). In contrast, pre-CPB and pre-to post-CPB RRI were not associated with AKI.
Conclusions: RRI obtained intraoperatively in cardiac surgery patients, assessed using previously reported thresholds, is highly associated with AKI and warrants further evaluation as a promising "earliest" AKI biomarker. These significant findings suggest that RRI assessment should be included in the standard intraoperative TEE exam.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: KL2 TR001115 United States TR NCATS NIH HHS; T32 GM008600 United States GM NIGMS NIH HHS; TL1 TR001116 United States TR NCATS NIH HHS; UL1 TR002553 United States TR NCATS NIH HHS
فهرسة مساهمة: Keywords: Acute kidney injury; Biomarker; Cardiac surgery; Renal resistive index; Transesophageal echocardiography
المشرفين على المادة: 0 (Biomarkers)
تواريخ الأحداث: Date Created: 20191109 Date Completed: 20210621 Latest Revision: 20210621
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC6962557
DOI: 10.1016/j.jclinane.2019.109626
PMID: 31699495
قاعدة البيانات: MEDLINE
الوصف
تدمد:1873-4529
DOI:10.1016/j.jclinane.2019.109626