Relazioni tra stiffness aortica ed indice di resistenzaintrarenale nell’ipertensione arteriosa

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Abstract

[automatically translated] For many years the study by echo-color-doppler of semiquantitative renal hemodynamic parameters was used to detect alterations in perfusion of the transplanted kidney, for the diagnosis of renal artery stenosis, or to assess the progression of some kidney diseases. More recently it has been observed that these parameters, and in particular of intrarenal resistance index (RI), are not only expression of parenchymal perfusion, but are also associated with systemic morpho-functional alterations of the vascular tree. Various studies have shown that aortic stiffness go increasing with the progressive deterioration of renal function. However, there are conflicting data in the literature on the existence of an independent relationship between aortic stiffness and IR. The aim of our study was to evaluate, in hypertensive patients (with and without impaired renal function), the relationship between RRI and arterial stiffness assessed by pulse wave wave velocity (PWV), aortic. subjects were enrolled between the ages of 30 and 70 years with BP> 140/90 mmHg or already receiving antihypertensive drugs. 2 groups were distinguished, one with normal renal function (n = 140) and one with chronic kidney disease (CKD) stage I-IV (n = 124). The aortic PWV was measured by automatic computerized method oscillometric, (arteriograph). The GFR was estimated using the CKD-EPI equation. The echo-Doppler examination of the renal arteries was performed by a single operator using GE LOGIQ P5 PRO unit with a transducer 4 MHz, operating at 2. 5 MHz for Doppler analysis. The Doppler signals were obtained by placing the sample volume at the interlobar arteries at the level of cortico-medullary junction. The IR [(VPS-VTD) / VPS] was calculated as the average of six measurements (three from each kidney). Patients with PWV> 12 m / sec showed higher IR values both in the totality of the population studied (p <0.001), both in the subgroups with and without CKD (in both cases p <0.01). Moreover, a direct correlation statistically significant was observed between aortic PWV and IR both in the entire study population (r 0.38; p <0.001) than in subgroups (r = 0:35; p <0.001) and without CKD (r = 0:31; p <0.001). These correlations were also statistically significant after adjustment for various confounding factors such as age, sex, mean arterial pressure, BMI, antihypertensive drug treatment, the estimated GFR. Our results, showing a strong correlation between IR and renal aortic PWV, seem to confirm that the IR, beyond its purely renal prognostic value, can be considered a "spy" of systemic vascular changes.
Original languageItalian
Pages (from-to)208-216
Number of pages9
JournalIPERTENSIONE E PREVENZIONE CARDIOVASCOLARE
Volume19
Publication statusPublished - 2012

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