Key result
A high arterial resistive index on admission predicted serum creatinine improvement with diuretic therapy in patients with cardiorenal syndrome type 1 (OR 6.25; 95% CI 1.84-14.3; P=0.003).
Why the study?
Recent studies showed an association between persistent systemic venous congestion and renal dysfunction, prompting investigation into how renal Doppler parameters change with diuretic therapy in CRS type 1.
Do renal vascular Doppler parameters predict serum creatinine improvement with diuretic therapy in patients with cardiorenal syndrome type 1?
Observational (n=64)
Do renal vascular Doppler parameters predict serum creatinine improvement with diuretic therapy in patients with cardiorenal syndrome type 1?
Effect estimate: OR 6.25 (95% CI 1.84-14.3)
p-value: p=0.003
High arterial resistive index on admission measured by renal Doppler sonography predicts serum creatinine improvement with diuretic therapy in patients with cardiorenal syndrome type 1.
May identify diuretic responders via renal Doppler in cardiorenal syndrome type 1; hypothesis-generating and should not yet change practice.
OBJECTIVES: Worsening of renal function in a patient with acute decompensated heart failure is called cardiorenal syndrome (CRS) type 1. Recent studies have shown an association of persistent systemic venous congestion with renal dysfunction. This trial was set up to investigate the changes of renal Doppler parameters with diuretic therapy in patients with CRS type 1. METHODS: Cases of CRS type 1 were identified among patients hospitalized for decompensated heart failure. Serial measurements of the renal venous impedance index (VII) and arterial resistive index (ARI) were calculated by pulsed wave Doppler sonography. RESULTS: A total of 30 patients who had creatinine improvement with diuresis (group 1) and 34 patients without any improvement (group 2) were analyzed. Patients in group 1 had higher median VII and ARI (VII, 0.86 versus 0.66; P < .001; ARI, 0.78 versus 0.65; P < .001) on admission. A high ARI on admission (odds ratio, 6.25; 95% confidence interval, 1.84-14.3; P = .003) predicted the improvement of serum creatinine levels with diuretic therapy independent of confounding factors in patients with CRS type 1. CONCLUSIONS: Renal vascular Doppler parameters might offer guidance on the diagnostic and therapeutic strategies in prescribing decongestive therapy for decompensated heart failure.
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Çakal et al. (2020) conducted an observational in Cardiorenal Syndrome Type 1 (n=64). Renal vascular Doppler sonography (arterial resistive index) was evaluated on Improvement of serum creatinine levels with diuretic therapy (OR 6.25, 95% CI 1.84-14.3, p=0.003). A high arterial resistive index on admission predicted serum creatinine improvement with diuretic therapy in patients with cardiorenal syndrome type 1 (OR 6.25; 95% CI 1.84-14.3; P=0.003).
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