0163: Renal arterial resistance index versus biomarkers for predicting acute kidney injury in acute heart failure

Abstract

Acute kidney injury (AKI) is frequent during acute heart failure (AHF) and worsens the outcome. To predict AKI is important but remains challenging. The aim of this study was to analyze Doppler-derived renal arterial resistance index (RRI) during AHF as well as its determinants and its predictive value of AKI as compared to renal biomarkers comprehensive echocardiographic examination and Doppler measurement of RRI were performed on admission, at day 3 and at discharge. RRI was the ratio (peak systolic velocity – end diastolic velocity)/ peak systolic velocity of interlobar blood flow. Serial assessment of clinical parameters as well as creatinine, cystatin C, blood NGAL, urinary NGAL and electrolytes was also obtained. AKI was defined by an increase in creatinine ≥ 0.3 mg/l relative to the admission level. Exclusion criteria was eGFR < 15 ml/min/1.73m² and atrial fibrillation. among the 26 included patients, AKI occurred in 8 patients at day 3 and in 10 patients at discharge. Mean RRI values were 0.71±0.08 on admission, 0.71±0.09 at day 3 and 0.74±0.08 at discharge. RRI was related to age, creatinine and cystatin C (p≤0.05 for all) but not to other clinical or echocardiographic variables or BNP or NGAL levels. Only admission RRI was significantly associated with AKI at day 3 (table) as well as RRI at day 3 for AKI at discharge (0.77±0.07 vs 0.67±0.8; p=0.02). this pilot study describes RRI values as well as its early changes and determinants during AHF. Doppler-derived RRI measurement appears to be a relevant tool for predicting AKI. Abstract 0163 – Table Admission variables No AKI AKI p Age 60±17 69±14 0.29 LVEF 25±8 33±17 0.78 Blood Pressure 122±18 118±19 0.63 eGFR 62±24 52±20 0.35 Cystacin C 1.4±0.6 1.8±0.7 0.08 NGAL blood 125±84 147±130 0.76 NGAL urinary 13±17 9 ±4 0.79 BNP 1979±1815 1562±881 0.95 IRR 0.68±0.08 0.76±0.06 0.03