Inrarenal Venous Flow PatterIntrarenal Venous Flow Patterns in Patients with Acute Heart Failure

Abstract

Intrarenal venous flow patterns are emerging tools in identifying renal venous congestion and its clinical significance in cardiorenal syndrome (CRS).

Objective: To study the distribution of intrarenal venous flow patterns (IRVF) and their relation to the development of acute kidney injury and prognosis in patients with acute heart failure.

Materials and methods: This is prospective, analytical study included 72 patients admitted with acute heart failure. Their medical history was taken, laboratory evaluation was conducted, and they were classified into three groups according to the IRVF pattern seen on intrarenal Doppler at admission. The occurrence of acute renal injury was recorded according to the RIFLE classification, and the outcomes were followed up, including hospitalization time, in-hospital death, and the need for permanent dialysis.

Results: Monophasic pattern was observed in 27 patients (37.5%), intermittent pattern in 21 patients (29.2%) and continuous pattern in 24 patients (33.3%). Acute kidney injury occurred in 44.4% of patients with monophasic pattern compared to 38% and 20% of patients in intermittent and continuous flow groups, respectively (P=0.01). Also, the prognosis was worse in terms of hospitalization duration and in-hospital death in monophasic pattern and diuretic resistance was observed in them at a higher rate.

Conclusion: Studying intrarenal venous flow patterns is useful for evaluating the reflection of hemodynamic changes in acute heart failure on the kidney and has a useful role in evaluating the prognosis in patients with acute heart failure.