• Ilaria Valeri, Paolo Persona, Emanuele Pivetta, Silvia De Rosa, Rossella Cescon, Enrico Petranzan, Michele Antonello, Franco Grego, and Paolo Navalesi.
• UOC Institute of Anaesthesia and Intensive Care Medicine, University Hospital of Padua, Padua, Italy.
• J. Cardiothorac. Vasc. Anesth. 2022 Aug 1; 36 (8 Pt B): 2968-2974.

ObjectiveAcute kidney injury (AKI) is a common perioperative complication in patients undergoing cardiovascular surgery, increasing mortality, morbidities, and costs. Recently, growing interest has risen in the use of the renal-resistive index (RRI) as a predictor of perioperative AKI. The aim of this study was to evaluate the role of RRI variation to identify postoperative AKI.DesignAn observational, prospective, pilot study.SettingDepartment of Vascular Surgery, University Hospital of Padova.ParticipantsThe study authors included 53 consecutive patients undergoing aortic surgery from September 2018 to June 2019.Measurements And Main ResultsBasal and daily postoperative serum creatinine and urine output were assessed. RRI was measured preoperatively and on the first postoperative day. AKI was defined using Kidney Disease Improving Global Outcome criteria. Twelve patients out of 53 developed AKI. The RRI percentage increase (%RRI) was associated with the development of AKI by univariate regression (p = 0.01). The receiver operating characteristic curve showed an overall diagnostic accuracy of 0.75 (95% confidence interval [CI], 58.2-92.6). The cutoff of 7 percentage points in the %RRI resulted in early identification of AKI onset with 90% specificity (95% CI, 76.9-97.3). The net benefit of postoperative RRI-based management was 11%.ConclusionsRRI variation could be a useful tool to investigate kidney function in patients undergoing aortic surgery. The %RRI in the perioperative time seems to detect AKI onset early and potentially could enhance renal-protective management within 24 hours after surgery.Copyright © 2022 Elsevier Inc. All rights reserved.

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