The renal resistive index (RRI), a Doppler ultrasound-derived parameter measuring renal vascular resistance, has emerged as a promising non-invasive tool to evaluate renal hemodynamics in critically ill patients, particularly those with acute respiratory distress syndrome (ARDS) and heart failure (HF). This narrative review examines the current evidence for RRI measurement in these conditions, exploring its physiological bases, methodology, clinical applications, and limitations. In ARDS, RRI reflects the complex interactions between positive pressure ventilation, hypoxemia, and systemic inflammation, showing a role in predicting acute kidney injury and monitoring response to interventions. In HF, RRI is able to assess venous congestion and cardiorenal interactions and can also serve as a prognostic indicator. Many studies have shown RRI’s superiority or complementarity to traditional biomarkers in predicting renal dysfunction, although its interpretation requires consideration of multiple patient-related fac

Giuseppe Cuttone, G.G. (2025). Exploring the Utility of Renal Resistive Index in Critical Care: Insights into ARDS and Cardiac Failure. BIOMEDICINES, 13(2), 312-324 [10.3390/biomedicines13020519].

Exploring the Utility of Renal Resistive Index in Critical Care: Insights into ARDS and Cardiac Failure

Giulio Geraci
Membro del Collaboration Group
;
Caterina Carollo
Ultimo
Supervision
2025-02-19

Abstract

The renal resistive index (RRI), a Doppler ultrasound-derived parameter measuring renal vascular resistance, has emerged as a promising non-invasive tool to evaluate renal hemodynamics in critically ill patients, particularly those with acute respiratory distress syndrome (ARDS) and heart failure (HF). This narrative review examines the current evidence for RRI measurement in these conditions, exploring its physiological bases, methodology, clinical applications, and limitations. In ARDS, RRI reflects the complex interactions between positive pressure ventilation, hypoxemia, and systemic inflammation, showing a role in predicting acute kidney injury and monitoring response to interventions. In HF, RRI is able to assess venous congestion and cardiorenal interactions and can also serve as a prognostic indicator. Many studies have shown RRI’s superiority or complementarity to traditional biomarkers in predicting renal dysfunction, although its interpretation requires consideration of multiple patient-related fac
19-feb-2025
Settore MEDS-08/B - Nefrologia
Settore MEDS-23/A - Anestesiologia
Settore MEDS-22/A - Diagnostica per immagini e radioterapia
Giuseppe Cuttone, G.G. (2025). Exploring the Utility of Renal Resistive Index in Critical Care: Insights into ARDS and Cardiac Failure. BIOMEDICINES, 13(2), 312-324 [10.3390/biomedicines13020519].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/673270
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