THE CORRELATION OF RENAL RESISTIVE INDEX AND SERUM CREATININE IN PREDICTING RENAL FUNCTION IN ACUTE URETERAL OBSTRUCTION.

Corresponding Author:
Dr. Nirmit Agrawal,
Kailas Medical, Guruwar Bazaar,
Washim-444505,
Maharashtra, India.
E-mail: nirmitagrawal1889@gmail.com

ABSTRACT

BACKGROUND

Early and accurate diagnosis of obstructive uropathy allows prompt and appropriate therapy, which is essential to minimise the devastating effects of urinary tract obstruction. The introduction of Duplex Doppler sonography can improve the clinical utility of ultrasonography. Doppler’s ability to characterise altered waveforms in response to elevations of renal vascular resistance may be used to calculate the Resistive Index (RI).

Aim- To find the values of the renal resistive index before and after relief of obstruction and to correlate these values with the corresponding values of serum creatinine in prognosis of recovery of renal function in the acute obstructive uropathy.

MATERIALS AND METHODS

This quasi-experimental study was conducted on patients attending inpatient and casualty departments in tertiary care hospital from December 2015 to October 2017. A total of 30 patients with bilateral ureteric obstruction were prospectively evaluated by measurement of RI before drainage and at 3 days, 1 week, 2 weeks and 4 weeks after drainage. Serum creatinine was measured at all points of RI examination.

RESULTS

In our study, the mean RI values of 30 bilateral ureteric obstruction decreased significantly from 0.772 ± 0.032 to 0.634 ± 0.025 at 3 days after drainage (p= 0.001) which is significant and 0.630 ± 0.017 at 7 days after drainage (p= 0.59) which is not significant and stabilised thereafter. Serum creatinine decreased significantly 1.718 ± 0.080 before drainage to 1.395 ± 0.095 (p= 0.001) mg/dL 3 days after drainage and then to 1.124 ± 0.103 mg/dL (p= 0.001) 7 days after drainage, which is also significant and stabilised thereafter.

CONCLUSION

In the acute bilateral ureteric obstruction, the RI has a correlation with serum creatinine in early post intervention days but not in late post intervention days. A reversal of a previously elevated RI could be used as an early indicator for renal function recovery.

KEY WORDS

Doppler Ultrasound, Resistive Index, Renal Function, Serum Creatinine, Ureteric Obstruction.