Abstract
Objective: This study aimed to test the validity and accuracy of renal resistive index (RRI) as an early predictor of acute kidney injury (AKI) in patients undergoing major abdominal surgery, compared with serum neutrophil gelatinase-associated lipocalin (NGAL).
Design: This was an observational study with a prospective cohort design.
Setting: The study was conducted at the Emergency Department and Intensive Care Unit of Wahidin Sudirohusodo Hospital, Makassar, from January to March 2025.
Patients and participants: All patients undergoing emergency major abdominal surgery with general anesthesia.
Measurement and results: RRI and serum NGAL levels were measured preoperatively and 24 hours postoperatively. To diagnose AKI according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, serum creatinine was measured within 48 hours after surgery. The results showed that preoperative and 24-hour postoperative serum RRI and NGAL levels were valid predictors of AKI in patients undergoing major abdominal surgery. Preoperative RRI obtained a sensitivity of 0.706 and a specificity of 0.737. Twenty-four-hour postoperative RRI obtained a sensitivity of 0.765 and a specificity of 0.789. Preoperative serum NGAL obtained a sensitivity of 0.647 and a specificity of 0.685. Twenty-four-hour postoperative serum NGAL obtained a sensitivity of 0.764 and a specificity of 0.737. Twenty-four-hour postoperative RRI produced the highest diagnostic accuracy of 77.78%.
Conclusions: The 24-hour postoperative RRI demonstrated the best validity and accuracy for predicting AKI in patients undergoing major abdominal surgery, compared with the preoperative RRI, NGAL, and 24-hour postoperative NGAL.
Prisia Riane Polii, Haizah Nurdin, Ari Santri Palinrungi, Syafri Kamsul Arif, Alamsyah Ambo Ala Husain, Charles Wijaya Tan
