• J. Cardiothorac. Vasc. Anesth. · Jan 2024

    Observational Study

    Association of Preoperative Renal-Resistive Index With Long-term Renal and Cardiovascular Outcomes After Cardiac Surgery.

    • Mårten Renberg, Ulrik Sartipy, Max Bell, and Daniel Hertzberg.
    • Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden. Electronic address: marten.renberg@regionstockholm.se.
    • J. Cardiothorac. Vasc. Anesth. 2024 Jan 1; 38 (1): 101108101-108.

    ObjectiveTo investigate the association of elevated preoperative renal-resistive index (RRI) with persistent renal dysfunction, major adverse kidney events (MAKE), and major adverse cardiovascular events (MACE) after cardiac surgery.DesignObservational cohort study.SettingUniversity hospital.ParticipantsNinety-six adult patients undergoing cardiac surgery.InterventionsRRI measurement the day before surgery.Measurements And Main ResultsFifty-eight patients (60%) had elevated RRI ≥0.70. Five years after surgery, persistent renal dysfunction (sustained decline in estimated glomerular filtration rate ≥25%) had occurred in 25 patients (26%), MAKE (persistent renal dysfunction, renal replacement therapy, or death) in 34 (35%), and MACE (myocardial infarction, unstable angina, decompensated heart failure, stroke, or cardiovascular death) in 28 (29%). RRI was higher in patients who developed persistent renal dysfunction (median, 0.78 [IQR, 0.74-0.82] v 0.70 [0.66-0.77], p = 0.001), MAKE (0.77 [0.72-0.81] v 0.68 [0.65-0.76], p = 0.002), and MACE (0.77 [0.72-0.81] v 0.70 [0.66-0.77], p = 0.006). Patients with elevated RRI had a significantly higher cumulative incidence of all long-term outcomes. After adjustment for baseline renal function and heart failure, elevated RRI was associated with persistent renal dysfunction (hazard ratio [HR], 5.82 [95% CI, 1.71-19.9]), MAKE (HR, 4.21 [1.59-11.1]), and MACE (HR, 2.81 [1.03-7.65]).ConclusionsElevated preoperative RRI is associated with persistent renal dysfunction, MAKE, and MACE after cardiac surgery. Preoperative RRI may be used for long-term risk assessment in patients undergoing cardiac surgery.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

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