Extraneous factors affecting resistive index.

Recently, numerous studies have referred to the resistive index as an accurate indicator of acute renal transplant rejection. We encountered several factors other than rejection that resulted in an elevation of the resistive index in both clinical and experimental situations. Any compressive effect on the kidney will elevate the resistive index. This compression may arise from an adjacent mass such as a fluid collection, most commonly hematoma, or even from excessive pressure transmitted via the transducer by a heavy-handed technician. Resistive index elevation also has been demonstrated in experimentally induced hypotension. Technically inaccurate scanning can yield a falsely low resistive index, but these previously mentioned entities can falsely elevate it, leading to an incorrect diagnosis of acute rejection.