Evaluation of the renal resistive index and pulsatility index in patients with pleural effusion by duplex Doppler ultrasonography

Degirmenci, Nevbahar Akcar; Metintaş, Muzaffer; Atlanoğlu, Şahinde; Yıldırım, Hüseyin

doi:10.1007/s11604-012-0142-z

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…In cardiovascular aging, characterized by disorganized medial elastic fibers and increased stiffness of small Frontiers in Physiology frontiersin.org renal arteries, the capacity of such small caliber vessels to dampen pulsatile flow decreases and become more permissive to the transmission of systemic pressure, which in turn could evoke a greater contractile response of the downstream afferent arterioles to increase renal vascular resistance and decrease renal plasma flow and GFR, or otherwise could cause barotraumatic injury to the glomerulus if these mechanisms at the afferent arteriolar level fail (Bidani and Griffin, 2004;Loutzenhiser et al, 2006;Williamson et al, 2008;Bidani et al, 2013). Previous evidence supporting this hypothesis has been obtained from non-invasive assessment of renal hemodynamics by Doppler sonography, which showed increases in the indices of impedance to flow, including resistive index and pulsatility index associated with age-related renal dysfunction (Warshauer et al, 1988;Salgado et al, 1999;Degirmenci et al, 2013). Using the same non-invasive approach in this study, we found that in young mice, elastin haploinsufficiency caused the augmentation of PI and RI as occurs in aging-induced vascular remodeling and a decline in renal function.…”

Section: Discussionmentioning

confidence: 99%

“…Images of renal arteries were acquired in B-mode with color Doppler setting to identify arterial blood flow. Peak systolic velocity (PSV), least diastolic velocity (LDV), and mean velocity (MV) determined from the renal Doppler waveforms were used to calculate resistive index (

) and pulsatility index (

), as previously described ( Warshauer et al, 1988 ; Salgado et al, 1999 ; Degirmenci et al, 2013 ; Jie et al, 2016 ; Koch et al, 2019 ). Each parameter was calculated in triplicate using three separate waveforms.…”

Section: Methodsmentioning

confidence: 99%

“…) and pulsatility index (PI (PSV−LDV) MV ), as previously described (Warshauer et al, 1988;Salgado et al, 1999;Degirmenci et al, 2013;Jie et al, 2016;Koch et al, 2019). Each parameter was calculated in triplicate using three separate waveforms.…”

Section: Psvmentioning

confidence: 99%

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Elastin haploinsufficiency accelerates age-related structural and functional changes in the renal microvasculature and impairment of renal hemodynamics in female mice

Dixon

Osei‐Owusu

2023

Front. Physiol.

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Age-related decline in functional elastin is associated with increased arterial stiffness, a known risk factor for developing cardiovascular disease. While the contribution of elastin insufficiency to the stiffening of conduit arteries is well described, little is known about the impact on the structure and function of the resistance vasculature, which contributes to total peripheral resistance and the regulation of organ perfusion. In this study, we determined how elastin insufficiency impinges on age-related changes in the structure and biomechanical properties of the renal microvasculature, altering renal hemodynamics and the response of the renal vascular bed to changes in renal perfusion pressure (RPP) in female mice. Using Doppler ultrasonography, we found that resistive index and pulsatility index were elevated in young Eln+/− and aged mice. Histological examination showed thinner internal and external elastic laminae, accompanied by increased elastin fragmentation in the medial layer without any calcium deposits in the small intrarenal arteries of kidneys from young Eln+/− and aged mice. Pressure myography of interlobar arteries showed that vessels from young Eln+/− and aged mice had a slight decrease in distensibility during pressure loading but a substantial decline in vascular recoil efficiency upon pressure unloading. To examine whether structural changes in the renal microvasculature influenced renal hemodynamics, we clamped neurohumoral input and increased renal perfusion pressure by simultaneously occluding the superior mesenteric and celiac arteries. Increased renal perfusion pressure caused robust changes in blood pressure in all groups; however, changes in renal vascular resistance and renal blood flow (RBF) were blunted in young Eln+/− and aged mice, accompanied by decreased autoregulatory index, indicating greater impairment of renal autoregulation. Finally, increased pulse pressure in aged Eln+/− mice positively correlated with high renal blood flow. Together, our data show that the loss of elastin negatively affects the structural and functional integrity of the renal microvasculature, ultimately worsening age-related decline in kidney function.

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Section: Discussionmentioning

confidence: 99%

) and pulsatility index (

Section: Methodsmentioning

confidence: 99%

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Elastin haploinsufficiency accelerates age-related structural and functional changes in the renal microvasculature and impairment of renal hemodynamics in female mice

Dixon

Osei‐Owusu

2023

Front. Physiol.

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“…What's more, in a case report of a patient with acute kidney injury in the course of a large pleural effusion, the authors suggested an interdependence between pleural effusion and kidney injury, which was attributed to neurohormonal derangements, affecting the secretion of natriuretic peptides and/or antidiuretic hormone [ 11 ]. In another study of patients having non-cardiac pleural effusion with normal blood pressure and renal function, the renal artery resistance index (RI) and pulsatility index (PI) of patients having effusion were higher than those normal controls [ 23 ]. The above hypotheses, suggesting that pleural effusion may lead to complicated pathophysiological changes in kidney through neurohumoral regulation, are proposed by clinical manifestations and rationality needs further verification.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury in hospitalized patients with nonmalignant pleural effusions: a retrospective cohort study

Wang,

Niu,

Chen

et al. 2024

BMC Nephrol

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Background Nonmalignant pleural effusion (NMPE) is common and remains a definite health care problem. Pleural effusion was supposed to be a risk factor for acute kidney injury (AKI). Incidence of AKI in NMPE patients and whether there is correlation between the size of effusions and AKI is unknown. Objective To assess the incidence of AKI in NMPE inpatients and its association with effusion size. Study design and method We conducted a retrospective cohort study of inpatients admitted to the Chinese PLA General Hospital with pleural effusion from 2018-2021. All patients with pleural effusions confirmed by chest radiography (CT or X-ray) were included, excluding patients with diagnosis of malignancy, chronic dialysis, end-stage renal disease (ESRD), community-acquired AKI, hospital-acquired AKI before chest radiography, and fewer than two serum creatinine tests during hospitalization. Multivariate logistic regression and LASSO logistic regression models were used to identify risk factors associated with AKI. Subgroup analyses and interaction tests for effusion volume were performed adjusted for the variables selected by LASSO. Causal mediation analysis was used to estimate the mediating effect of heart failure, pneumonia, and eGFR < 60 ml/min/1.73m2 on AKI through effusion volume. Results NMPE was present in 7.8% of internal medicine inpatients. Of the 3047 patients included, 360 (11.8%) developed AKI during hospitalization. After adjustment by covariates selected by LASSO, moderate and large effusions increased the risk of AKI compared with small effusions (moderate: OR 1.47, 95%CI 1.11-1.94 p = 0.006; large: OR 1.86, 95%CI 1.05-3.20 p = 0.028). No significant modification effect was observed among age, gender, diabetes, bilateral effusions, and eGFR. Volume of effusions mediated 6.8% (p = 0.005), 4.0% (p = 0.046) and 4.6% (p < 0.001) of the effect of heart failure, pneumonia and low eGFR on the development of AKI respectively. Conclusion The incidence of AKI is high among NMPE patients. Moderate and large effusion volume is independently associated with AKI compared to small size. The effusion size acts as a mediator in heart failure, pneumonia, and eGFR.

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Vascular Doppler ultrasonographic indices in cirrhosis: a case–control study with emphasis on the common carotid arteries

et al. 2015

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Evaluation of the renal resistive index and pulsatility index in patients with pleural effusion by duplex Doppler ultrasonography

Abstract: Pleural effusion might result in increased renal impedance as seen in cirrhosis, which is a rather complicated pathophysiological process, without causing any morphological changes in kidneys.

Cited by 5 publications

References 24 publications

Elastin haploinsufficiency accelerates age-related structural and functional changes in the renal microvasculature and impairment of renal hemodynamics in female mice

Elastin haploinsufficiency accelerates age-related structural and functional changes in the renal microvasculature and impairment of renal hemodynamics in female mice

Acute kidney injury in hospitalized patients with nonmalignant pleural effusions: a retrospective cohort study

Vascular Doppler ultrasonographic indices in cirrhosis: a case–control study with emphasis on the common carotid arteries

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