Renal resistive index and cardiovascular organ damage in a large population of hypertensive patients

Tedesco, Michele Adolfo; Natale, Francesco; Mocerino, Rosa; Tassinario, Guido; Calabrò, Raffaele

doi:10.1038/sj.jhh.1002145

Cited by 89 publications

(84 citation statements)

References 32 publications

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“…33,36 A relationship between RRI and IMT was also reported. 8,21,34,35 In our study, the correlation between RRI, RV/RRI and hsCRP persisted even after adjustment for age, IMT and PP, which are all related to systemic atherosclerosis and arterial stiffness. The high RRI and low RV/RRI values observed in our patients could mainly detect intrarenal tubulo-interstitial and arteriolar inflammatory damage associated with systemic low-grade inflammation, whilst 'extrarenal' RRI and RV/RRI determinants seem to have a minor role.…”

Section: Discussionsupporting

confidence: 47%

“…In fact, elevations in hsCRP have been associated with reduced arterial elasticity 27 and increased arterial stiffness measured by pulse wave velocity (PWV), 28,29 and the relationship between hsCRP and IMT as an early marker of atherosclerosis was shown. 30,31 Moreover, a strict dependence of RRI from arterial stiffness was demonstrated in experimental studies, 8,26 and an association was confirmed between RRI and PP, 21,[32][33][34][35] and between RRI and PWV. 33,36 A relationship between RRI and IMT was also reported.…”

Section: Discussionmentioning

confidence: 75%

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Renal resistive index and low-grade inflammation in patients with essential hypertension

et al. 2011

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In essential hypertension, increased renal resistive index (RRI) is associated to a reduction of renal function and microalbuminuria, and to renal tubulo-interstitial damage. A tubulo-interstitial inflammatory infiltration was found in experimental models of hypertension, and serum high-sensitive C-reactive protein (hsCRP) levels correlated with urinary markers of tubulointerstitial damage in humans. We studied the relationship between RRI and serum hsCRP in hypertensives with preserved renal function, without microalbuminuria. We investigated hypertensive patients without diabetes, renal failure, microalbuminuria or major inflammatory disease. Serum levels of hsCRP were assayed. RRI was calculated by intrarenal Doppler ultrasound and considered pathologic when X0.70 or 495% of upper confidence limit expected for age decade. The renal volume-to-resistive index ratio (RV/RRI) was also calculated. We evaluated 85 patients (57 ± 14 years, 61 males). Patients with pathologic RRI (n ¼ 21) were older and had significantly higher hsCRP levels (4.70 ± 2.30 vs 2.93 ± 2.09 mg l À1 , Po0.01) compared with patients with normal RRI, as well as patients with decreased RV/RRI (n ¼ 43). HsCRP was directly related with RRI (r ¼ 0.41, Po0.001) and inversely with RV/RRI (r ¼ À0.35, Po0.001). HsCRP proved to be a significant predictor of both pathologic RRI and decreased RV/RRI, even after adjustment. In essential hypertension low-grade inflammation is associated with tubulo-interstitial damage evaluated by Doppler ultrasonography.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 75%

Renal resistive index and low-grade inflammation in patients with essential hypertension

et al. 2011

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“…Studies in subjects with kidney diseases showed an association between renal resistance indices and local renal impairment, demonstrating their ability to predict kidney diseases. Few studies investigated the association between intra-renal hemodynamic indices and carotid IMT exclusively in subjects with hypertension [9,27,31], with chronic kidney diseases [32] or kidney transplanted [33]. A major limitation of these studies, though, was their rather small sample sizes [9,27,32].…”

Section: Discussionmentioning

confidence: 99%

Intra-renal hemodynamics and carotid intima-media thickness in the metabolic syndrome

Buscemi

Verga

Batsis

et al. 2009

Diabetes Research and Clinical Practice

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“…Indeed, it has recently been suggested that RI might be a marker of the cardiovascular risk in the hypertensive. 14 We suggest that this could be accounted for by its relations with both the micro-and the macrocirculations.…”

Section: Introductionmentioning

confidence: 88%

“…The existence, in hypertensive patients, of a significant correlation between RI and impairments of target organs (urinary albumin/creatinine ratio, the index of left ventricular mass and intima media thickness 14,33 ) points to RI being a marker of cardiovascular risk. 33 Our results are consistent with this view by showing that RI is an integral compound index of both micro-and macrovascular impairments.…”

Section: Impairment Of Porh But Not Hyperhemy At 44 1c In the Hypertementioning

confidence: 99%

Impairment of skin blood flow during post-occlusive reactive hyperhemy assessed by laser Doppler flowmetry correlates with renal resistive index

2011

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We lack non-invasive tools for evaluating the coronary and renal microcirculations. Since cutaneous Doppler laser exploration has evidenced impaired cutaneous microvascular responses in coronary artery disease and in impaired renal function, we wanted to find out if there was a link between the impairments in the cutaneous and renal microcirculations. To specify the significance of the rise in the renal resistive index (RI), which is still unclear, we also sought relations between RI and arterial stiffness. We conducted a cross-sectional controlled study in a heterogeneous population including hypertensive patients of various ages with or without a history of cardiovascular disease along with a healthy control group. The cutaneous microcirculation was evaluated by laser Doppler flowmetry of the post-occlusive reactive hyperhemy (PORH) and of the hyperhemy to heat. The renal microcirculation was evaluated by measurement of the RI. Arterial stiffness was evaluated from an ambulatory measurement of the corrected QKD 100-60 interval. We included 22 hypertensives and 11 controls of mean age 60.6 vs 40.8 years. In this population, there was a correlation between RI and basal zero to peak flow variation (BZ-PF) (r ¼ À0.42; P ¼ 0.02) and a correlation between RI and rest flow to peak flow variation (RF-PF) (r ¼ À0.44; P ¼ 0.01). There was also a significant correlation between RI and the corrected QKD 100-60 (r ¼ À0.47; P ¼ 0.01). The significant correlation between PORH parameters and RI indicates that the functional modifications of the renal and cutaneous microcirculations tend to evolve in parallel during ageing or hypertension. The relation between RI and arterial stiffness shows that RI is a compound index of both renal microvascular impairment and the deterioration of macrovascular mechanics.

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Renal resistive index and cardiovascular organ damage in a large population of hypertensive patients

Cited by 89 publications

References 32 publications

Renal resistive index and low-grade inflammation in patients with essential hypertension

Renal resistive index and low-grade inflammation in patients with essential hypertension

Intra-renal hemodynamics and carotid intima-media thickness in the metabolic syndrome

Impairment of skin blood flow during post-occlusive reactive hyperhemy assessed by laser Doppler flowmetry correlates with renal resistive index

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