Ioannis Bellos1, Vasilios Pergialiotis2, Konstantinos Kontzoglou3. 1. Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece. Electronic address: bellosg@windowslive.com. 2. Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece. 3. Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Greece; 2nd dpt of Propedeutic Surgery, "Laikon" General Hospital, National and Kapodistrian University of Athens, Greece.
Abstract
PURPOSE: To determine the efficacy of Doppler renal resistive index in the prediction of acute kidney injury after major surgery. METHODS: A systematic review and meta-analysis of cohort studies was conducted. Medline (1966-2018), Scopus (2004-2018), Clinicaltrials.gov (2008-2018) and Google Scholar (2004-2018) databases were systematically searched. Prospective studies that examined the diagnostic accuracy of renal resistive index in postoperative acute kidney injury were included. RESULTS: The meta-analysis was based on 10 studies, including a total number of 911 patients. Patients who developed acute kidney injury presented higher renal resistive index values preoperatively (MD: 0.02, 95% CI: [0.00-0.03]), immediately after surgery (MD: 0.07, 95% CI: [0.04-0.11]) and 24 hours postoperatively (MD: 0.07, 95% CI: [0.04-0.09]). The pooled sensitivity was 81.8%, the specificity 77.6% and the area under the curve 0.866. Fagan's nomogram indicated that the post-test probability was increased to 60.6% (positive test) and decreased to 9.5% (negative test), when the pre-test probability was 30%. CONCLUSIONS: Renal resistive index represents a useful marker with fair performance in the prediction of postoperative acute kidney injury. Future cohorts should establish the optimal timing of measurement and evaluate the most appropriate cut-off value that should be used in the clinical setting.
PURPOSE: To determine the efficacy of Doppler renal resistive index in the prediction of acute kidney injury after major surgery. METHODS: A systematic review and meta-analysis of cohort studies was conducted. Medline (1966-2018), Scopus (2004-2018), Clinicaltrials.gov (2008-2018) and Google Scholar (2004-2018) databases were systematically searched. Prospective studies that examined the diagnostic accuracy of renal resistive index in postoperative acute kidney injury were included. RESULTS: The meta-analysis was based on 10 studies, including a total number of 911 patients. Patients who developed acute kidney injury presented higher renal resistive index values preoperatively (MD: 0.02, 95% CI: [0.00-0.03]), immediately after surgery (MD: 0.07, 95% CI: [0.04-0.11]) and 24 hours postoperatively (MD: 0.07, 95% CI: [0.04-0.09]). The pooled sensitivity was 81.8%, the specificity 77.6% and the area under the curve 0.866. Fagan's nomogram indicated that the post-test probability was increased to 60.6% (positive test) and decreased to 9.5% (negative test), when the pre-test probability was 30%. CONCLUSIONS: Renal resistive index represents a useful marker with fair performance in the prediction of postoperative acute kidney injury. Future cohorts should establish the optimal timing of measurement and evaluate the most appropriate cut-off value that should be used in the clinical setting.
Authors: Armando Coca; Carlos Arias-Cabrales; María José Pérez-Sáez; Verónica Fidalgo; Pablo González; Isabel Acosta-Ochoa; Arturo Lorenzo; María Jesús Rollán; Alicia Mendiluce; Marta Crespo; Julio Pascual; Juan Bustamante-Munguira Journal: Sci Rep Date: 2022-02-10 Impact factor: 4.996