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Войти в исследования Cardiology in the young · 2026
Six-hour renal resistive index as an early marker of acute kidney injury after infant cardiac surgery: a prospective cohort study.
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Elsaoudi Ahmed R, Kazzaz Yasser, Ismail Sameh Rabie, Jijeh Abdulraouf M Z, Shaath Ghassan A, Altaweel Hayan, Hijazi Omar, Qadi Ammar M H, Kabbani Mohamed S, Hamadah Hussam K
Аннотация
BACKGROUND: Acute kidney injury after infant congenital cardiac surgery is common and worsens outcomes. Renal resistive index may aid early postoperative risk stratification.
OBJECTIVE: To evaluate a single six-hour postoperative renal resistive index as an early acute kidney injury marker and its association with postoperative haemodynamic support.
METHODS: A prospective single-centre cohort of neonates and infants < 12 months (n = 41) was classified as acute kidney injury (n = 19) or non-acute kidney injury (n = 22). Renal resistive index was measured at six hours (primary), 48 hr, and discharge. Postoperative acute kidney injury was diagnosed using Kidney Disease: Improving Global Outcomes serum creatinine and urine output criteria over 48 hr. Vasoactive-inotropic score was recorded, and discrimination was assessed using receiver operating characteristic analysis.
RESULTS: At six hours, renal resistive index was higher in acute kidney injury vs. non-acute kidney injury (0.84 ± 0.07 vs. 0.74 ± 0.08; p = 0.0002) with good unadjusted discrimination (area under the curve 0.83; 95% CI 0.68-0.97). Surgical complexity was higher in the acute kidney injury group (median STAT 4 vs. 3). At 48 hr, renal resistive index remained higher (p = 0.017; area under the curve 0.70), while discharge values were similar (p = 0.18; area under the curve 0.62). A six-hour renal resistive index < 0.80 excluded moderate-to-severe acute kidney injury, whereas ≥ 0.86 identified a higher risk. Vasoactive-inotropic score at 48 hr was higher in acute kidney injury (7.2 ± 8.1 vs. 1.9 ± 3.4; p = 0.009), and six-hour renal resistive index correlated modestly with inotropic burden (r = 0.56; p < 0.001). Three acute kidney injury infants required peritoneal dialysis, all with six-hour renal resistive index ≥ 0.90.
CONCLUSIONS: A six-hour renal resistive index may help early acute kidney injury risk assessment after infant cardiac surgery. External validation is warranted.
OBJECTIVE: To evaluate a single six-hour postoperative renal resistive index as an early acute kidney injury marker and its association with postoperative haemodynamic support.
METHODS: A prospective single-centre cohort of neonates and infants < 12 months (n = 41) was classified as acute kidney injury (n = 19) or non-acute kidney injury (n = 22). Renal resistive index was measured at six hours (primary), 48 hr, and discharge. Postoperative acute kidney injury was diagnosed using Kidney Disease: Improving Global Outcomes serum creatinine and urine output criteria over 48 hr. Vasoactive-inotropic score was recorded, and discrimination was assessed using receiver operating characteristic analysis.
RESULTS: At six hours, renal resistive index was higher in acute kidney injury vs. non-acute kidney injury (0.84 ± 0.07 vs. 0.74 ± 0.08; p = 0.0002) with good unadjusted discrimination (area under the curve 0.83; 95% CI 0.68-0.97). Surgical complexity was higher in the acute kidney injury group (median STAT 4 vs. 3). At 48 hr, renal resistive index remained higher (p = 0.017; area under the curve 0.70), while discharge values were similar (p = 0.18; area under the curve 0.62). A six-hour renal resistive index < 0.80 excluded moderate-to-severe acute kidney injury, whereas ≥ 0.86 identified a higher risk. Vasoactive-inotropic score at 48 hr was higher in acute kidney injury (7.2 ± 8.1 vs. 1.9 ± 3.4; p = 0.009), and six-hour renal resistive index correlated modestly with inotropic burden (r = 0.56; p < 0.001). Three acute kidney injury infants required peritoneal dialysis, all with six-hour renal resistive index ≥ 0.90.
CONCLUSIONS: A six-hour renal resistive index may help early acute kidney injury risk assessment after infant cardiac surgery. External validation is warranted.