Journal of Nephrology

, Volume 32, Issue 4, pp 527–538 | Cite as

Renal intraparenchymal resistive index: the ultrasonographic answer to many clinical questions

  • Pierpaolo Di NicolòEmail author
  • Antonio Granata


The use of renal resistive indices (RRIs) for the study of renal microcirculation has in the past been proposed for the identification of renal organ damage or even to specifically identify injury to some areas of the renal parenchyma. Nevertheless, according to the most recent evidences from literature this organ-based conception of RRIs has been proven to be partial and unable to explain the RRIs variations in clinical settings of sepsis or combined organ failure of primitively extrarenal origin or, more generally, the deep connection between RRIs and hemodynamic factors such as compliance and pulsatility of the large vessels. The aim of this review is to explain the physiopathological basis of RRIs determination and the most common interpretative errors in their analysis. Moreover, through a comprehensive vision of these Doppler indices, the traditional and emerging clinical application fields for RRIs are discussed.


Renal resistive index Renal Doppler ultrasonography Point of care ultrasonography 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Italian Society of Nephrology 2018

Authors and Affiliations

  1. 1.Nephrology and Dialysis Unit“S. Maria della Scaletta” HospitalImolaItaly
  2. 2.Nephrology and Dialysis Unit“S. Giovanni di Dio” HospitalAgrigentoItaly

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