Kidney Diseases in Critical Ill Patients

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 1437

Special Issue Editor


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Guest Editor
Unit of Nephrology and Dialysis, Hypertension Excellence Centre, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy
Interests: nephrocardiology; chronic renal failure; hypertension
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Special Issue Information

Dear Colleagues,

Critical patients are an important field of research. This kind of medical care requires special treatment, and in such a context as kidney diseases could worsen a patient’s clinical course and outcome. During hospitalization in critical care units, the onset of an acute kidney disease increases mortality. The pathophysiology of AKI in critically ill patients is complex and multifactorial, where an imbalance of electrolytes and fluids, heart failure, anemia, and other conditions require particular expertise and multiple approaches in which nephrologists should be involved. Diagnostics, especially noninvasive and bedside methods, are fundamental for specialists to take the best therapeutic approach, which could also require extracorporeal methods that should be adapted to these frail patients.

These important topics will be the main focus of this Special Issue.

Dr. Caterina Carollo
Guest Editor

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Keywords

  • acute kidney disease
  • critical care
  • beside diagnostics
  • point of care ultrasounds
  • dialysis

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Published Papers (1 paper)

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Review

16 pages, 785 KiB  
Review
Exploring the Utility of Renal Resistive Index in Critical Care: Insights into ARDS and Cardiac Failure
by Giuseppe Cuttone, Giulio Geraci, Luigi La Via, Massimiliano Sorbello, Federico Pappalardo and Caterina Carollo
Biomedicines 2025, 13(2), 519; https://doi.org/10.3390/biomedicines13020519 - 19 Feb 2025
Viewed by 1201
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 [...] Read more.
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 factors. Key challenges include operator dependency, lack of standardization, and complex interpretation in multi-organ dysfunction. Future research should focus on measurement standardization, development of automated techniques, investigation of novel applications like intraparenchymal renal resistive index variation, and validation of RRI-guided management strategies. Despite its limitations, RRI represents a valuable tool that offers bedside and real-time insights into renal hemodynamics and potential guidance for therapeutic interventions. Further research is needed to fully clarify its clinical potential and address current limitations, particularly in critical care settings involving multiple organ dysfunction. Full article
(This article belongs to the Special Issue Kidney Diseases in Critical Ill Patients)
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