Acute Kidney Disease, Acute Kidney Injury, Cardiac Surgery, Chronic Kidney Disease, Renal Resistive Index
Conditions
Brief summary
Renal resistive index (RRI) is calculated from ultrasonographic Doppler measurements of flow velocities in intraparenchymal renal arteries. Normal values are around 0.60, and 0.70 is considered the upper normal threshold in adults. Both preoperative and postoperative elevation of RRI has shown promise in early detection of AKI after cardiac surgery. Further, elevated RRI before coronary angiography is associated with an increased risk of cardiovascular complications up to 1 year after the procedure. The role of preoperative RRI in predicting long-term renal and cardiovascular complications after elective surgery is however not known. The aim of this study is to assess the role of preoperative RRI to predict the risk of persistent renal dysfunction as well as renal- and cardiovascular complications up to 5 years after surgery.
Interventions
None listed
Sponsors
Region Stockholm
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥18 * Elective coronary artery bypass grafting, heart valve surgery, or aortic surgery performed at Karolinska University Hospital between September 2014 and April 2015 * Preoperative measurement of RRI performed with satisfactory Doppler reading * Written informed consent
Exclusion criteria
* Kidney transplant * Dialysis-dependent kidney disease * Cancelled surgery * Missing follow-up data
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Long-term renal dysfunction | 5 years after surgery or end of follow-up | Reduced estimated glomerular filtration rate (eGFR) ≥25% from baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Short-term renal dysfunction | 30 days after surgery | Reduced eGFR ≥25% from baseline |
| Intermediate renal dysfunction | 90 days after surgery | Reduced eGFR ≥25% from baseline |
| Major adverse kidney events (MAKE) | 30 days, 90 days, 1 year, and 5 years after surgery or end of follow-up | Composite outcome during follow-up time including one of; death, renal replacement therapy, reduced eGFR ≥25% from baseline |
| Major adverse cardiac and cerebrovascular events (MACCE) | 30 days, 90 days, 1 year, and 5 years after surgery or end of follow-up | Composite outcome during follow-up time including one of; death, myocardial infarction, heart failure, stroke |
Countries
Sweden
Outcome results
None listed