Índice de resistencia de la arteria renal como predictor para el inicio de diálisis en paciente con falla renal aguda

Abstract

Acute kidney injury (AKI) has increased its prevalence globally nowadays; knowing about the renal artery resistance index indicates the level of irrigation that the kidneys present, whose increase in the cut-off values indicates a failure in perfusion or the renal parenchyma. Therefore, Doppler ultrasound and renal arterial resistive index (RI) assessment represent fundamental tools for the treatment of acute renal failure. However, RI is not a single factor so it is important to evaluate it together with clinical, biochemical, and hemodynamic factors, allowing for more accurate and personalized decision-making regarding the management of acute kidney injury. Updated research on patients with a diagnosis of AKI categorized in Kidney Disease: Improving Global Outcomes (KDIGO) stage 3 with complications indicates that the RI as a predictor for dialysis initiation shows a sensitivity between 75 - 91.5% and a specificity between 70 - 90%. In conclusion, once kidney condition is confirmed and dialysis is subsequently implemented, RI helps in therapeutic follow-up because abnormalities may occur, such as the presence of volume and hemodynamics fluctuations, indicating further management. Therefore, an increase in cut-off values once dialysis has been implemented would be indicative of disease progression.