Should renal color Doppler ultrasonography be a routine test in newly diagnosed hypertensive patient?

Tsioufis, Costas; Andrikou, Ioannis; Pruijm, Menno; Ponte, Belén; Sarafidis, Pantelis A.; Κουρέας, Ανδρέας; Tousoulis, Dimitrios; Agabiti‐Rosei, Enrico; Mancia, Giuseppe; Burnier, Michel

doi:10.1097/hjh.0000000000001508

Cited by 8 publications

(8 citation statements)

References 68 publications

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“…The color Doppler ultrasound can achieve ideal diagnostic results through the changes of renal size, renal cortical thickness, and ultrasonic parameters [ 27 ]. The advantage of Doppler ultrasound lies not only in the examination of renal morphological abnormalities but also in the monitoring of renal function [ 28 ]. By detecting changes in intrarenal blood flow, the color Doppler, energy Doppler, and spectral analysis can provide qualitative or quantitative hemodynamic information about the intrarenal and extrarenal vasculature.…”

Section: Discussionmentioning

confidence: 99%

Renal Doppler Ultrasound in the Evaluation of Renal Function in Patients with Sepsis

Zhao

et al. 2022

Applied Bionics and Biomechanics

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This study was aimed to explore the renal Doppler ultrasound in the evaluation of renal function in patients with sepsis. Fifty patients with sepsis or septic shock were classified into the acute kidney injury (AKI) group (n =25) and the non-AKI group (n =25) according to whether they had AKI. The measurements of renal resistance index (RRI) and power Doppler ultrasound (PDU) were performed on all patients within 7 days of admission to the intensive care unit (ICU). The patient’s renal function was assessed. The results showed that the RRI of the two groups showed a slight upward trend over time, and the RRI of the AKI group was higher than that of the non-AKI group. After 7 days in AKI group, the areas under the receiver operating characteristic (ROC) curves of RRI were 0.745, 0.683, 0.729, 0.856, 0.793, 0.819, and 0.836 (P <0.05). There were no statistically considerable differences in areas under ROC curves between the two groups (P >0.05). The grouping of AKI and the time were both fixed effects, and the individual patients were randomized effects. Besides, the linear models were statistically analyzed. The results showed that the differences between the two groups were statistically insignificant (P >0.05). There was no significant difference in the PDU scores measured at different times within 7 days after ICU admission between the two groups (P >0.05). In conclusion, renal Doppler ultrasound had a good adoption effect in the evaluation of the renal function of patients with severe sepsis, which is worth promoting in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Renal Doppler Ultrasound in the Evaluation of Renal Function in Patients with Sepsis

Zhao

et al. 2022

Applied Bionics and Biomechanics

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“…Today determination of albuminuria, calculation of the eGFR, and realization of a renal color Doppler ultrasound [52] are recommended by the European Society of Cardiology/ European Society of Hypertension hypertension guidelines [15] to calculate the global cardiovascular risk, to diagnose secondary forms of hypertension, and to assess target organ damage at the renal level. In theory, the addition of a RFR estimation could provide additional information to clinicians identifying a subset of patients who might perhaps benefit from more intensive BP goals and particularly from a closer follow-up of their renal function, implementing renal preventive measures such as the prescription of nephroprotective drugs, the avoidance of nephrotoxic agents, and the introduction of an effective cardiovascular protection by multifaceted interventions to risk factors.…”

Section: Discussionmentioning

confidence: 99%

Renal Functional Reserve Is Related to the Nondipping Phenotype and to the Exercise Heart Rate Response in Patients with Essential Hypertension and Preserved Renal Function

Damianaki

Burnier

Dimitriadis

et al. 2020

Kidney Blood Press Res

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Background: Renal functional reserve (RFR), defined as the difference between stress and resting glomerular filtration rate (GFR), may constitute a diagnostic tool to identify patients at higher risk of developing acute kidney injury or chronic kidney disease. Blunted RFR has been demonstrated in early stages of hypertension and has been attributed to impaired vascular reactivity due to an overactive sympathetic nervous system (SNS). Objective: The purpose of this study was to investigate whether RFR correlates with other phenotypes expressing overactivity of the SNS in patients with essential hypertension and preserved renal function. Methods: Thirty-six patients with untreated essential hypertension and a GFR >60 mL/min/1.73 m2 were enrolled. The following parameters were measured: RFR, 24-h ambulatory blood pressure (BP) profile, a treadmill stress test, and an echocardiographic examination. Urine and venous samples were obtained at specific time points for the determination of clinical parameters, and both resting and stress GFR were calculated by using endogenous creatinine clearance for the measurement of RFR after an acute oral protein load (1 g/kg). Results: Twenty-one patients had a RFR <30 mL/min/1.73 m2 and 15 had a RFR above this cutoff. A nondipping pattern of 24-h BP was significantly more frequent in patients with low RFR (57.1 vs. 25.0%, p < 0.05 for systolic BP and 52.3 vs. 10.0%, p < 0.02 for diastolic BP). Moreover, patients with lower RFR values showed a blunted heart rate (HR) response to exercise during treadmill test (r = 0.439, p < 0.05). None of the echocardiographic parameters differed between the two groups of patients. Conclusions: In hypertensive patients with preserved GFR, reduced RFR is related to nondipping BP phenotype as well as to attenuated exercise HR response. Overactivity of the SNS may be a common pathway. Since loss of RFR may represent a risk factor for acute or chronic kidney injury, hypertensive patients with blunted RFR might need a more careful renal follow-up.

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“…Pour l'aspect technique de cet examen, il faut se mettre en Bmode, avec une vue en transverse et long axe, afin de pouvoir observer le pôle inférieur, supérieur et la partie moyenne des reins, et mesurer leurs dimensions. 4 La taille habituelle des reins est de 10 à 12 cm. On calcule leur volume selon la formule ellipsoïde de la manière suivante : longueur × largeur × profondeur × 0,523 (figure 1).…”

Section: Examen Morphologiqueunclassified

Apport de l’échographie rénale dans l’hypertension artérielle

Dash¹,

Pruijm²,

Ponte³

2020

Revue Médicale Suisse

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The kidneys play a central role in the regulation of blood pressure and are also one of the main culprits of arterial hypertension (HT). Renal ultrasound is a valuable diagnostic tool that can provide instant information at the bedside on possible underlying causes and consequences of HT. Its role in the screening for renal artery stenosis is well-known. However, renal ultrasound can also detect abnormalities in renal parenchyma, morphology, or the vascularization of the kidneys, and as such directly influence further diagnostic work-up and treatment. The significance of the renal resistive index and the place of renal ultrasound in the latest international guidelines on HT are reviewed in this article.

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Should renal color Doppler ultrasonography be a routine test in newly diagnosed hypertensive patient?

Cited by 8 publications

References 68 publications

Renal Doppler Ultrasound in the Evaluation of Renal Function in Patients with Sepsis

Renal Doppler Ultrasound in the Evaluation of Renal Function in Patients with Sepsis

Renal Functional Reserve Is Related to the Nondipping Phenotype and to the Exercise Heart Rate Response in Patients with Essential Hypertension and Preserved Renal Function

Apport de l’échographie rénale dans l’hypertension artérielle

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