Renal Resistive Index as an Early Predictor of Renal Involvement in Cirrhotic Patient

Abstract

Background: In India, cirrhosis and chronic liver disease (CLD) were responsible for 2.1% of all fatalities. One of the most significant clinical and prognostic consequences of liver cirrhosis is acute kidney Injury (AKI). In this context, renal progression of AKI is a warning indication of a significant risk of death. It has been noted that renal vascular constriction in cirrhosis patients increases the renal resistive index (RRI). The study aims to evaluate the predictive significance of duplex Doppler ultrasonography in a group of liver disease patients who are not azotemic.

Materials and Methods: It was a prospective observational cohort study that was conducted in the Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India. The study has been conducted from January 2022 to December 2023. The study included 136 participants in total. Ethical approval has been granted from the Institutional Ethics Committee (IEC), IGIMS, Patna, Bihar, India, under letter number 835/IEC/IGIMS/2022 dated 10 December 2022.

Results: The mean age of participants was 45.00 ± 11.92 years. 85.3% of the participants were Male, while 14.7% were Female. Creatinine at baseline and RRI at Baseline showed a weak positive connection, although this relationship was not statistically significant for those who developed AKI at one month. The outcomes of participants during follow-up tend to be uneventful in 71 (52.6%) patients, Readmitted patients 53 (39.3%), and expired patients 11 (8.1%) in number.

Conclusion: The study concluded that acute kidney injury has the highest clinical and prognostic significance and is a frequent consequence of liver cirrhosis. AKI is more likely to develop in patients with cirrhosis, particularly decompensated cirrhosis than in those without cirrhosis. Percentage change in creatinine versus RRI at one month, three months, and six months was found to be statistically significant. RRI may be used as a marker for AKI prediction and outcome in patients with cirrhosis.

Keywords: Acute Kidney Injury, Renal Resistive Index, Chronic liver disease, non-azotemic, Liver Diseases, Renal Impairment