The Relationship Between IRRIV and RFR Under Pathologic Conditions (IRRIV-RFR)

Ospedale San Bortolo di Vicenza

Status: Completed

Conditions: Acute Kidney Injury

Study type: Observational

Funder types: Other

Identifiers

NCT03756376

35/14

Details and patient eligibility

About

The assessment of renal functional reserve (RFR) has been proposed for the risk stratification of patients undergoing potentially nephrotoxic procedures. The present pilot study is designed to explore the correlation between IRRIV and RFR under pathologic conditions.

Full description

Renal functional reserve (RFR) represents the capacity of the kidney to increase glomerular filtration rate (GFR) in response to certain physiological or pathological stimuli or conditions.

RFR is calculated as the difference between the measured maximum GFR achieved through a renal stress test and the baseline GFR measured in rest conditions. In clinical practice, the most common renal stress test is performed as a standardized protein loading test. Recently, in a pilot study, the investigators demonstrated a significant correlation between RFR and the intra-parenchymal renal resistive index variation (IRRIV) during an echo renal stress test in a cohort of healthy volunteers. IRRIV test has proven to be rapid, safe, bedside and easy to perform and it might represent a preliminary test in screening patients' RFR.The present pilot study is designed to explore the correlation between IRRIV and RFR under pathologic conditions.

Enrollment: 31 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Estimated GFR (CKD-EPI) greater than or equal to 60 mL/min/1.73 m2
• Scheduled cardiac surgery with cardiopulmonary bypass (coronary artery bypass, valve replacements, combined or other operations).

Exclusion criteria

• Age less than 18 years old
• Pregnancy
• Ultrasound evidence of morphological kidney abnormalities and/or renal artery stenosis
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Contrast media in the 2 days before the tests.

Trial design

31 participants in 1 patient group

IRRIV and RFR

Description:

Enrolled patients will receive IRRIV test and RFR assessment. RFR will be evaluated through a protein loading test. (1.2 g of protein/Kg of body weight) performed with cooked beef. The RFR was then defined as the difference between the highest CrCl obtained after the protein load and the baseline CrCl measured on rest conditions. Concerning the IRRIV test, a weight of 10% of the patient's body weight is applied on the abdominal wall. RRIs is recorded in a middle interlobular artery, every minute for 10 minutes during the echo-renal stress test. The lowest RRI reached is taken as reference (stress RRI). The IRRIV is defined as the percentage difference between baseline RRI and stress RRI