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This study aims to investigate the predictive value of Doppler-based renal ultrasound and urinary oxygen tension in the development of acute kidney injury after cardiac surgery.
Cardiac surgery-associated acute kidney injury (CSA-AKI) is a complication following cardiac surgery occurring in 15-30% of patients. It is associated with increased morbidity and mortality as well as prolonged hospital stay and higher medical costs.
The renal artery pulsatility index (RAPI), which is determined using Doppler measurements, has been reported to detect patients with a high risk of AKI. Additionally, the renal resistance index (RRI), measured by Doppler ultrasound, can accurately predict the occurrence of AKI.
Urinary oxygen partial pressure in the bladder has been shown to decrease in the setting of sepsis, reduced renal blood flow, and decreased cardiac output.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study group | Patients undergoing elective on-pump cardiac surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Renal resistive index | Other | It will be measured with ultrasound-Doppler using an abdominal curvilinear probe ultrasonography by two independent, trained sonographers (who will not be involved in patient care). After visualizing the kidney in ultrasound mode and checking for renal abnormalities, an arcuate or inter-lobar artery will be localized, and three successive Doppler measurements at different positions in the kidney (high, middle, and low) will be performed. The average value for each kidney will be taken. The renal resistive index will be calculated as follows: (systolic peak flow velocity - diastolic minimum flow velocity)/systolic peak flow velocity |
| Measure | Description | Time Frame |
|---|---|---|
| Number of cases developed acute kidney injury | Number of cases developed acute kidney injury as defined by KIDGO guidelines (serum creatinine ≥ 0.3 mg/dL from base line within 48 hours, or ≥1.5 fold within 7 days, or urine output <0.5 mL/kg/hour for six hours) in patients undergoing open heart surgery. | 7 days after the procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Length of intensive care unit stay | The length of stay in an Intensive Care Unit (ICU) is defined as the duration a patient spends in the ICU, typically measured from the time of admission to the ICU until the time of discharge. | 7 days after the procedure |
| Length of hospital stay |
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Inclusion Criteria:
Exclusion Criteria:
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This prospective cohort observational study will be conducted at Tanta University Hospitals for a period of at least two years, from October 2024 to September 2026, pending approval from the institutional ethics committee.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Amany M Badr, Master | Contact | 00201018038038 | amany.badr@med.tanta.edu.eg |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Recruiting | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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|
| Renal Artery Pulsatility Index | Other | It will be measured using an abdominal curvilinear probe ultrasonography by two independent, trained sonographers (who will not be involved in patient care). After visualizing the kidney, the interlobular artery will be located using color Doppler mode, and the velocity of the interlobular arteries will be assessed in one or two kidneys. The Renal Artery Pulsatility Index (RAPI) will be calculated as follows: RAPI = [(peak systolic velocity) - (end diastolic velocity)] /average velocity |
|
| Urinary oxygen tension (PUO2) | Other | Urinary oxygen tension (PUO2) will be measured preoperatively (baseline), postoperatively just after intensive care unit admission, 12 hours after surgery, and then once daily for 7 days. |
|
Length of hospital stay will be measured from admission till discharge from hospital. |
| 7 days after the procedure |
| Need for renal replacement therapy | Need for renal replacement therapy will be recorded. | 7 days after the procedure |
| Number of patients developed chronic kidney disease | Number of patients developed chronic kidney disease will be recorded. | 7 days after the procedure |
| Mortality rate | Mortality rate will be recorded. | 7 days after the procedure |
| ID | Term |
|---|---|
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D051437 | Renal Insufficiency |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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