ASSOCIATION OF RENAL RESISTIVE INDEX WITH AORTIC PULSE WAVE VELOCITY IN HYPERTENSIVE PATIENTS.

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Abstract

The assessment of renal hemodynamic parameters by duplex Doppler sonographyhas been used for many years as a diagnostic tool in the daily work-up ofkidney diseases. Recent data suggest that these parameters, especially the intrarenalresistive index (RI) may be also associated with systemic vascular changesand with an enhanced cardiovascular risk.However, conflicting data exist in literature about the independent associationof aortic stiffness with RI.The aim of this study was to evaluate the relationship between RI and arterialstiffness, assessed by aortic pulse wave velocity (PWV), in the hypertensivesubjects consecutively attending our hypertension centre.We enrolled 264 subjects, aged between 30 and 70 years. They were divided intotwo groups, either with normal renal function (n = 140) or with chronic kidney disease(CKD), ranging from stage 1 to stage 4 of the KDIGO classification (n = 124).The aortic PWV was measured by a computerized oscillometric method (Arteriograph).The GFR was estimated by CKD-EPI equation. A single operatorperformed duplex Doppler assessment of the renal arteries. Dopplersignals were obtained by placing the sample volume along the course of theinterlobar arteries. The RI was calculated as the average of six measurements(three from each kidney).Patients with PWV> 12 m/sec showed higher values of RI, both in theoverall population (p <0.001) and in the subgroups with (p<0.01) and withoutCKD (p<0.01). In addition, a statistically significant correlation wasobserved between aortic PWV and RI in the whole population (r = 0.38, p<0.001) and in the subgroups with (r = 0.35, p <0.001) and without CKD (r= 0:31, p <0.001). These correlations held even after adjustment for severalconfounding factors.Our results, showing a strong independent association between renal RI andaortic PWV, seem to corroborate the concept that the RI, beyond its prognosticrenal value, may be considered as a marker of systemic vascular changes andtherefore a predictor of cardiovascular risk.
Lingua originaleEnglish
Paginee527-e527
Numero di pagine1
Stato di pubblicazionePublished - 2013

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