Renal intraparenchymal resistive index: the ultrasonographic answer to many clinical questions

Nicolò, Pierpaolo Di; Granata, Antonio

doi:10.1007/s40620-018-00567-x

Cited by 48 publications

(45 citation statements)

References 96 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The IRI is the result of a complex interaction between the kidney and the systemic vessels. Although not fully understood, IRI is widely accepted as a useful tool for studying renal microcirculation and can provide diagnostic and prognostic information in many different settings 39 . However, a review study concluded that IRI is not speci c for an individual disease; however, in a selected group of patients, it could be used as a good marker of cardiovascular-renal changes and a predictor of kidney events and mortality 40 .…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the Intrarenal Resistivity Index As A Cardiovascular Risk Marker in Afro-Descendants: An Observational, Cross-Sectional Study

Souza

Lages

Magalhaes

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Cardiovascular diseases are a major cause of morbidity and mortality in Brazil and worldwide. Stratification of the risk of these diseases in asymptomatic patients using biomarkers can lead to early detection of patients at high risk of cardiovascular disease and promote the prevention of relevant events. The intrarenal resistivity index (IRI) is an imaging test that assesses renal perfusion, systemic hemodynamics, and atherosclerosis. It has been reported that changes in IRI are associated with morbidity and mortality in a population of patients with hypertension, diabetes, and chronic kidney disease. The present study tested a hypothesis that IRI is associated with imaging biomarkers of cardiovascular risk in a population of Afro-descendants. Methods: A total of 313 Afro-descendants with high cardiovascular risk were assessed using kidney ultrasound, Doppler echocardiography, carotid Doppler, and computed tomography to assess the calcium score. The individuals were divided into Group 1 with normal IRI and Group 2 with high IRI. Results: The mean intrarenal resistivity index was 0.61 in group 1 and 0.71 in group 2, and the mean age was 56.9 years, with 53% being female. Group 2 had significantly greater left ventricular mass, larger left atrium, and a higher prevalence of diastolic dysfunction (34.5% vs. 66.7%, p<0.0001). Group 2 also had a significantly higher frequency of carotid plaque (31% vs. 64%, p<0.001) as well as total coronary artery calcium score and higher frequency of high coronary artery calcium score (56.37 vs. 212.03, p<0.0001 and 24% vs. 50%, p<0.001, respectively). The presence of diastolic dysfunction with high left atrial pressure, coronary artery calcium score >0, and carotid plaque was independently associated with the intrarenal resistivity index. Conclusions: The intrarenal resistivity index is associated with imaging biomarkers of cardiovascular risk, mainly with the coronary artery calcium score, diastolic dysfunction, and atherosclerotic carotid plaque in people of African descent, with high cardiovascular risk.

show abstract

Section: Discussionmentioning

confidence: 99%

Usefulness of the Intrarenal Resistivity Index As A Cardiovascular Risk Marker in Afro-Descendants: An Observational, Cross-Sectional Study

Souza

Lages

Magalhaes

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Acting as functional supply reservoir, “core organs” protect themselves from hypotension until the insufficient DO2 determines cellular apoptosis and organ failure [2] becoming a multi-organ dysfunction syndrome (MODS) etiopathogenetic factor [1], as it has been demonstrated in animal and human models. A likely explanation could be found in the high sensitivity of kidney to ischemic damage owing to its complex microvascular structure along with its high metabolic needs [10]. Deruddre et al showed that measurement of RRI could represent a new tool to identify the optimal individual MAP to sustain renal blood flow and could help managing norepinephrine titration during septic shock treatment [19].…”

Section: Discussionmentioning

confidence: 99%

“…RRI can be calculated as (peak systolic velocity − end diastolic velocity)/peak systolic velocity [10].…”

Section: Introductionmentioning

confidence: 99%

Renal resistive index: a new reversible tool for the early diagnosis and evaluation of organ perfusion in critically ill patients: a case report

et al. 2019

View full text Add to dashboard Cite

Background We reported a case of early detection of peripheral hypoperfusion trough the evaluation of a new index in intensive care: Renal Doppler Resistive Index (RRI). Case presentation We admitted a 76-year-old man who underwent ileostomy and hernioplasty because of an intestinal occlusion due to obstructive strangulated right inguinal hernia. The post-operative period was characterised by hemodynamic instability and he needed an invasive hemodynamic monitoring, administration of vasopressors and continuous renal replacement therapy (CRRT). Then, hemodynamic stability was obtained and vasopressors interrupted. RRI was lower than 0.7. In the eleventh post-operative day, despite stable macrocirculatory parameters, we found increased values of RRI. An abdomen ultrasound first and then a CT scan revealed the presence of bleeding from the previous ileostomy. Hence, the patient immediately underwent another surgical operation. Conclusions RRI modification appears to be more precocious than any other hemodynamic, microcirculatory and metabolic parameter routinely used. RRI has been widely used to assess renal function in critically ill patients; now, we presume that RRI could represent a common and useful tool to manage target therapy in critical condition.

show abstract

“…Patients were categorized into two groups based on the commonly used cutoff value of RRI of 0.7 [14]. Group comparisons were performed with Student’s t-test, χ 2 test, and Mann–Whitney U test, as appropriate.…”

Section: Methodsmentioning

confidence: 99%

Intrarenal resistive index conundrum: systemic atherosclerosis versus renal arteriolosclerosis

et al. 2019

View full text Add to dashboard Cite

Background: We aimed to evaluate the relationship between biopsy-proven kidney lesions, subclinical markers of atherosclerosis and intrarenal resistive index (RRI) in chronic kidney disease (CKD) patients.Methods: This cross-sectional, single-center study prospectively enrolled 44 consecutive CKD patients (57% male gender, 54.1 (95%CI, 49.7–58.6) years, median eGFR 28.1 (15.0–47.7) mL/min) diagnosed by renal biopsy during 6 months in our clinic. RRI, carotid intima-media thickness (IMT), Kauppila score for abdominal aortic calcification (AACs) were assessed. Traditional and nontraditional atheroscleosis risk factors were also evaluated.Results: Most of the patients had a diagnosis of glomerular nephropathy, with IgA nephropathy and diabetic nephropathy being the most frequent. RRI increased proportionally with CKD stages. Patients with RRI >0.7 (39%) were older, had diabetic and vascular nephropathies more frequently, higher mean arterial blood pressure, increased systemic atherosclerosis burden (IMT and AACs), higher percentage of global glomerulosclerois, GBM thickness, arteriolosclerosis and interstitial fibrosis/tubular atrophy. RRI directly correlated with age (rs = 0.55, p < 0.001) and with all the studied atherosclerosis markers (clinical atherosclerosis score rs = 0.50, p = 0.02; AACs rs = 0.50, p < 0.01; IMT rs = 0.34, p = 0.02). Also, global glomerulosclerosis (rs = 0.31, p = 0.03) and interstitial fibrosis/tubular atrophy (rs = 0.35, p = 0.01) were directly correlated with RRI. In multivariable adjusted binomial logistic regression models, only arteriolosclerosis was retained as independent predictor of RRI >0.7.Conclusion: The analysis of RRI may be useful in the evaluation of the general vascular condition of the patient with CKD, supplying information about both microvascular and macrovascular impairment. Moreover, RRI correlates well with renal histopathologic characteristics, particularly with arteriolosclerosis.

show abstract

Renal intraparenchymal resistive index: the ultrasonographic answer to many clinical questions

Cited by 48 publications

References 96 publications

Usefulness of the Intrarenal Resistivity Index As A Cardiovascular Risk Marker in Afro-Descendants: An Observational, Cross-Sectional Study

Usefulness of the Intrarenal Resistivity Index As A Cardiovascular Risk Marker in Afro-Descendants: An Observational, Cross-Sectional Study

Renal resistive index: a new reversible tool for the early diagnosis and evaluation of organ perfusion in critically ill patients: a case report

Intrarenal resistive index conundrum: systemic atherosclerosis versus renal arteriolosclerosis

Contact Info

Product

Resources

About