Resistivity and pulsatility indexes in feline kidney disease: a systematic review

Doppler ultrasonography is used in the evaluation of hemodynamics, and the resistivity (RI) and pulsatility (PI) indexes provide information about resistance to blood flow within a vessel. This systematic review was carried out to evaluate renal RI and PI in clinically healthy and nonsedated cats and as well as their usefulness in the evaluation of kidney disease in cats. An electronic search in the PubMed, Scopus, and Web of Science databases was carried out using the terms "resistive index" or "resistivity index" or "pulsatility index;" "Doppler;" "renal" or "kidney;" and "cat" or "feline" in titles, abstracts, and keywords. Variables of interest related to experimental model features, research methods, and technical resources were extracted from the studies. The methodological quality was assessed with SYRCLE's risk of bias tool. Thus, 14 studies involving healthy and sick cats were selected. Interestingly, the upper limits estimated for both RI and PI varied among studies. The upper limits of renal RI for healthy cats varied between 0.64 and 0.72, while for PI, the values varied from 1.06 to 1.29. A limited number of studies evaluated cats with kidney disease. In most studies, RI values of kidneys with different conditions were significantly different from kidneys of healthy animals, indicating that RI values increase with kidney disease. The parameters body weight, heart rate, and age seem to influence the RI values. Standardized studies regarding its realization and description are still necessary to define normal values and analyze its applicability in the clinical diagnostic routine.