SYSTEMIC ARTERIAL CHANGES AND PULSE PRESSURE: DIFFERENT IMPACT ON RENAL HAEMODYNAMICS IN HYPERTENSIVE PATIENTS.

Giuseppe Mule', Giulio Geraci, Santina Cottone, Calogero Geraci, Giuseppa Costanza, Manuela Mogavero

Risultato della ricerca: Otherpeer review

Abstract

Objective: Renal resistance index (RRI) is used for kidney disease detectionand prognosis, but it also appears a good indicator of systemic vascular changesin hypertensive subjects. Structural atherosclerotic damage, arterial stiffness andpulse pressure may interact each other, and the relationship between intrarenalhaemodynamics and systemic vascular alterations has been widely investigated.However, the independent impact of all these parameters on renal haemodynamicsand the mechanisms by which they affect renal vasculature remain to beclarified.Design and method: We enrolled 463 hypertensive patients (30–70 years)with normal renal function (group 0; n = 280) and with chronic kidney disease(groups IV;n = 183). All subjects underwent ultrasonographic examination ofintrarenal and carotid vasculature, as well as a 24hambulatory blood pressuremonitoring.Results: A statistically significant difference in RRI, carotid intimamediathickness(cIMT), aortic pulse wave velocity (aPWV) and clinic pulse pressure (PP) wasobserved in the different 6 groups (all p < 0.001), even after adjustment for age. RRIstrongly correlated with cIMT (r = 0.460, p < 0.001), aPWV (r = 0.386, p < 0.001),clinic PP (r = 0.279, p < 0.001) and 24hPP (r = 0.229, p < 0.001) in the entire studypopulation. These correlations were similar in subjects with and without renal dysfunction.In the overall study population, the association between RRI, cIMT andclinic PP remained statistically significant even after adjustment for various confoundingfactors (figure 1) (respectively b=0.258; p < 0.001; b=0.117; p = 0.006),whereas the relationship between RRI and aPWV was lost in multivariate analysis.Conclusions: cIMT and clinic PP rather than directly aPWV are associated withintrarenal haemodynamics. Our results confirm that RRI may be considered as arenal window of systemic vascular tree, independently of level of renal function.
Lingua originaleEnglish
Pagine331-331
Numero di pagine1
Stato di pubblicazionePublished - 2015

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