Acute Kidney Injury, Doppler-Based Renal Ultrasound, Open Heart Surgery, Urinary Oxygen Tension
Conditions
Brief summary
This study aims to investigate the predictive value of Doppler-based renal ultrasound and urinary oxygen tension in the development of acute kidney injury after cardiac surgery.
Detailed description
Cardiac surgery-associated acute kidney injury (CSA-AKI) is a complication following cardiac surgery occurring in 15-30% of patients. It is associated with increased morbidity and mortality as well as prolonged hospital stay and higher medical costs. The renal artery pulsatility index (RAPI), which is determined using Doppler measurements, has been reported to detect patients with a high risk of AKI. Additionally, the renal resistance index (RRI), measured by Doppler ultrasound, can accurately predict the occurrence of AKI. Urinary oxygen partial pressure in the bladder has been shown to decrease in the setting of sepsis, reduced renal blood flow, and decreased cardiac output.
Interventions
It will be measured with ultrasound-Doppler using an abdominal curvilinear probe ultrasonography by two independent, trained sonographers (who will not be involved in patient care). After visualizing the kidney in ultrasound mode and checking for renal abnormalities, an arcuate or inter-lobar artery will be localized, and three successive Doppler measurements at different positions in the kidney (high, middle, and low) will be performed. The average value for each kidney will be taken. The renal resistive index will be calculated as follows: (systolic peak flow velocity - diastolic minimum flow velocity)/systolic peak flow velocity
OTHERRenal Artery Pulsatility Index
It will be measured using an abdominal curvilinear probe ultrasonography by two independent, trained sonographers (who will not be involved in patient care). After visualizing the kidney, the interlobular artery will be located using color Doppler mode, and the velocity of the interlobular arteries will be assessed in one or two kidneys. The Renal Artery Pulsatility Index (RAPI) will be calculated as follows: RAPI = \[(peak systolic velocity) - (end diastolic velocity)\] /average velocity
OTHERUrinary oxygen tension (PUO2)
Urinary oxygen tension (PUO2) will be measured preoperatively (baseline), postoperatively just after intensive care unit admission, 12 hours after surgery, and then once daily for 7 days.
Sponsors
Tanta University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age above 21 years. * Both sexes. * Undergoing elective on-pump cardiac surgery.
Exclusion criteria
* Patients with chronic kidney disease. * Patients with any renal pathology or anatomic kidney abnormalities. * Patients on renal replacement therapy.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of cases developed acute kidney injury | 7 days after the procedure | Number of cases developed acute kidney injury as defined by KIDGO guidelines (serum creatinine ≥ 0.3 mg/dL from base line within 48 hours, or ≥1.5 fold within 7 days, or urine output \<0.5 mL/kg/hour for six hours) in patients undergoing open heart surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Length of intensive care unit stay | 7 days after the procedure | The length of stay in an Intensive Care Unit (ICU) is defined as the duration a patient spends in the ICU, typically measured from the time of admission to the ICU until the time of discharge. |
| Length of hospital stay | 7 days after the procedure | Length of hospital stay will be measured from admission till discharge from hospital. |
| Need for renal replacement therapy | 7 days after the procedure | Need for renal replacement therapy will be recorded. |
| Number of patients developed chronic kidney disease | 7 days after the procedure | Number of patients developed chronic kidney disease will be recorded. |
| Mortality rate | 7 days after the procedure | Mortality rate will be recorded. |
Countries
Egypt
Contacts
Primary ContactAmany M Badr, Master
Outcome results
None listed