Perioperative medicine & outcomes
Doppler-Derived Renal Functional Reserve in the Prediction of Postoperative Acute Kidney Injury in Patients Undergoing Robotic Surgery
Authors' conclusion
Our findings show that the preoperative assessment of Doppler-derived RFR combined with baseline renal function improves the capability of identifying patients at high risk for PO-AKI with eGFR >60 mL/min/1.73 m2 after robotic abdominal surgery in Trendelenburg position for pelvic oncological disease.
Study context
- Population
- Patients with baseline estimated glomerular filtration rate (eGFR) >60 mL/min/1.73 m² undergoing robotic abdominal surgery in the Trendelenburg position for pelvic oncological disease
- Participants
- 53 patients
- Comparison
- Doppler-derived renal functional reserve (RFR) vs serum creatinine vs eGFR for predicting postoperative acute kidney injury (PO-AKI)
- Outcome
- Capability of Doppler-derived RFR in predicting PO-AKI (ROC-AUC)
- Follow-up
- First 3 postoperative days
Methodological detailsdouble-blinded
- Double-blinded
Performance
As reported in the abstract
ROC-AUC for PO-AKI
| Test or model | AUC |
|---|---|
| Serum creatinine | 0.85 (95% CI, 0.74-0.97; P = .007) |
| eGFR | 0.84 (95% CI, 0.71-0.96; P = .006) |
| delta-RRI | 0.84 (95% CI, 0.78-0.91; P = .017) |
| delta-RRI + eGFR | 0.95 (95% CI, 0.9-1) |
AUC
Serum creatinine0.85 (95% CI, 0.74-0.97; P = .007)
eGFR0.84 (95% CI, 0.71-0.96; P = .006)
delta-RRI0.84 (95% CI, 0.78-0.91; P = .017)
delta-RRI + eGFR0.95 (95% CI, 0.9-1)
Further findings
Incidence of PO-AKI · first 3 postoperative days
- Patients developing AKI (approximately)
- 15.1%
Physiologic delta-RRI (≥0.05)
- Physiologic delta-RRI
- 31 (58.5%)
- No physiologic delta-RRI
- 22 (41.5%)
Original publication
Doppler-Derived Renal Functional Reserve in the Prediction of Postoperative Acute Kidney Injury in Patients Undergoing Robotic Surgery. Anesth Analg. Published 17 June 2024. doi:10.
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