Utilidad del índice de resistencia renal en la valoración y evolución de la uropatía obstructiva. Estudio experimental

Abstract

ObjectiveThe study was focused on determining the effectiveness and reliability of using the renal resistance index as a method of diagnosing and monitoring the evolution of obstructive uropathy treatment. For this purpose, we conducted an experimental study on a homogenous group of animals that all had the same level of obstruction. Material and methods15 healthy female pigs were used. The experiment was divided into three phases: phase I consisted of a study prior to unilateral pyeloureteral junction obstruction, performing retrograde ureteropyelography, renal Bmode ultrasound and duplex-Doppler (of both kidneys) at a level of the arcuate arteries. Then, the obstruction was performed on the animals. Phase II commenced by diagnosing the lesion, 6 weeks after the previous phase, by means of the aforementioned diagnostic methods. Finally, the endourological treatment was completed. Animals were monitored (Phase III) 15 weeks after the endopyelotomy, using the same methods as in the study, by assessing the urinary tract (fluoroscopy) and both kidneys by determining the renal resistance index and ratio. ResultsAll the animals in the study showed signs of urinary obstruction on radiology and renal ultrasound 6 weeks after ureteral ligature. After treatment and follow-up, all animals showed signs of having recovered from the obstructive uropathy. Values of ?RI during the 3 phases are detailed below. Fase I ?IR = 0.01, Fase II ?IR = 0.11, Fase III ?IR = 0.02. ConclusionRI determination using duplex-Doppler is effective for distinguishing obstructive dilatation using non-invasive techniques. However, this parameter provides very slight differences and it can also be influenced by too many direct and indirect factors (observational, patient age, anaesthesia, haemodynamic parameters, etc.), to supplant the classic diagnostic methods.