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ORIGINAL ARTICLE
Year : 2019  |  Volume : 63  |  Issue : 7  |  Page : 551-557

Doppler resistive index to reflect risk of acute kidney injury after major abdominal surgery: Aprospective observational trial


1 Department of Anesthesiology, Assured Best Care Hospital Pvt Ltd, Trichy, Tamil Nadu, India
2 Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India
3 Department of Radiodiagnosis, JIPMER, Puducherry, India

Correspondence Address:
Dr. Satyen Parida
Qr. No. D(II) 18, JIPMER Campus, Dhanvantari Nagar, Puducherry - 605 006
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_189_19

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Background and Aims: Doppler renal resistive index(RI) has been studied to find its association with postoperative acute kidney injury(AKI). This study was conducted to evaluate the usefulness of preoperative RI, postoperative RI and RI variation before and after surgery expressed as a percentage(% RI) for early AKI detection in major abdominal surgery. Methods: This was a single-centre, prospective observational trial performed in the critical care unit of an academic hospital. Eligible patients posted for major abdominal surgery under general anaesthesia using intraperitoneal approach with at least two predefined risk factors for AKI were included in the study. Renal RI was measured preoperatively and on postoperative day zero. Statistical comparisons were performed for various parameters between the AKI and the non-AKI groups. Pre-and postoperative RI receiver operating characteristics(ROC) curves were drawn and areas under the curves computed. Positive and negative predictive values, sensitivity, specificity and positive and negative likelihood ratios were calculated. Results: A total of 69 subjects were enrolled, of which 14 developed AKI in the postoperative period. The mean resistive indices measured were 0.65±0.09 and 0.74±0.09 in the pre-and postoperative periods, respectively. The area under the ROC curve in the postoperative RI was 0.732 with 95% confidence intervals of 0.592–0.871. This most accurate cut-off value to detect postoperative AKI with sensitivity 57.1% and specificity of 85.5% was 0.77. Conclusion: Postoperative RI can detect early AKI after major abdominal surgery.


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