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Abstract
Acute kidney injury (AKI) is a frequent and severe complication in cardiac surgery. Normal renal function is dependent on adequate renal perfusion, which may be altered in the perioperative period. Renal perfusion can be assessed with Doppler measurement. We aimed to determine the association between Doppler measurements of renal perfusion and the development of AKI. This was a prospective, observational study of 100 patients with ≥ one risk factor for postoperative AKI undergoing open-heart surgery. Doppler ultrasound examinations were performed before surgery and on the first and fourth postoperative day. AKI was defined according to the KDIGO criteria and subdivided into mild (KDIGO stage 1) and severe AKI (KDIGO stage 2 + 3). Thirty-three patients developed AKI, 25 developed mild and eight developed severe AKI. Abnormal renal venous flow pattern on the first postoperative day was significantly associated with the development of severe AKI (OR 8.54 (95% CI 1.01; 72.2), P = 0.046), as were portal pulsatility fraction (OR 1.07 (95% CI 1.02; 1.13), P = 0.005). Point-of-care Doppler ultrasound measurements of renal perfusion are associated with the development of AKI after cardiac surgery. Renal and portal Doppler ultrasonography can be used to identify patients at high risk or very low risk of AKI after cardiac surgery.
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1 Aarhus University Hospital, Department of Cardiothoracic and Vascular Surgery, Anaesthesia Section, Aarhus N, Denmark (GRID:grid.154185.c) (ISNI:0000 0004 0512 597X); Aarhus University, Department of Clinical Medicine, Aarhus N, Denmark (GRID:grid.7048.b) (ISNI:0000 0001 1956 2722)
2 University of the Witwatersrand, Department of Anaesthesiology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa (GRID:grid.11951.3d) (ISNI:0000 0004 1937 1135)
3 Aarhus University Hospital, Department of Cardiothoracic and Vascular Surgery, Anaesthesia Section, Aarhus N, Denmark (GRID:grid.154185.c) (ISNI:0000 0004 0512 597X)
4 University of the Witwatersrand, Division of Cardiology, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa (GRID:grid.11951.3d) (ISNI:0000 0004 1937 1135)
5 Aarhus University Hospital, Department of Radiology, Aarhus N, Denmark (GRID:grid.154185.c) (ISNI:0000 0004 0512 597X)
6 Aarhus University, Department of Clinical Medicine, Aarhus N, Denmark (GRID:grid.7048.b) (ISNI:0000 0001 1956 2722); Aarhus University Hospital, Department of Intensive Care, Aarhus N, Denmark (GRID:grid.154185.c) (ISNI:0000 0004 0512 597X)