The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

Petersen, Lone; Petersen, Jesper; Talleruphuus, Ulrik; Ladefoged, Søren; Mehlsen, J; Jensen, H A

doi:10.1093/ndt/12.7.1376

Cited by 160 publications

(135 citation statements)

References 12 publications

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“…19 Hypertension may cause nephrosclerosis or glomerulosclerosis, reducing the intrarenal vascular surface area and increasing vascular resistance even in the unaffected kidney. 20 The evaluation of RRI in hypertensive patients reveals significantly higher values than normotensive subjects, even without overt nephropathy. 21 Nevertheless, lower RRI values were associated with low renal and CV target organ damage.…”

Section: Discussionmentioning

confidence: 98%

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

et al. 2007

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We evaluated the relationship between renal resistive index (RRI) of the intrarenal vasculature and cardiovascular (CV) organ damage such as left ventricular hypertrophy (LVH), diastolic dysfunction and carotid atherosclerosis in a large sample of hypertensive patients. 566 hypertensive patients underwent echocardiography with conventional Doppler and Doppler tissue imaging (DTI), carotid and renal ultrasonography. In addition, lipids profile, creatinine in serum, and urinary albumin concentrations were determined. The patients were divided according to their RRI values in 2 groups: o70 and X70. Subjects with high RRI were older, had higher systolic and pulse pressure (PP) and more years of hypertension, compared to those with low RRI (Po0.0001). Patients with the higher RRI showed an increased left ventricular mass index (LVMI) and carotid intima-media thickness (IMT) with a higher prevalence of LVH, carotid plaques and microalbuminuria (Po0.001). There were differences in overall diastolic parameters, in particular when evaluated by DTI (Po0.001). A positive correlation was found between RRI and age, PP, carotid IMT, LVMI, SBP and a negative correlation was found with DTI diastolic parameters (Po0.001). Age, PP, carotid IMT and LVMI were independently related to RRI. While, RRI was independently related to IMT and IVRT. RRI, especially the higher values, are positively correlated with target organ damage in hypertensive patients, indicating that renal vascular resistance is related to morphologic and hemodynamic alteration of the CV system. The evaluation of RRI could predict the presence of early CV damage and provide an accurate estimate of overall risk.

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Section: Discussionmentioning

confidence: 98%

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

et al. 2007

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“…Previous studies revealed that the RI was a useful predictor of renal dysfunctions [11][12][13][14][15][16] and correlated significantly with organ damage. Measurement of RI in addition to low-grade albuminuria is reportedly useful for target organ damage screening in patients with resistant Blood pressure variability and renal function T Kawai et al hypertension.…”

Section: Discussionmentioning

confidence: 98%

“…[11][12][13][14][15][16] We previously reported that the RI might be a more efficacious parameter for the evaluation of very early renal damage than estimated glomerular filtration rate (eGFR). 17 It is thought that renal vascular damage caused by atherosclerotic risk factors such as hypertension and variability of BP could be evaluated more precisely by the RI.…”

Section: Introductionmentioning

confidence: 99%

The impact of visit-to-visit variability in blood pressure on renal function

et al. 2011

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Hypertension is an important risk factor for cardiovascular diseases such as chronic kidney disease. It is still not fully understood how blood pressure impacts the kidneys. In this study, we aimed to establish the significance of visit-to-visit variability in blood pressure for renal function. We analyzed 143 consecutive patients undergoing renal Doppler ultrasonography in our hospital ward and measured blood pressure at outpatient visits six or more times. We analyzed the correlation between visit-to-visit variability in blood pressure and multiple clinical parameters, including albuminuria and resistive index evaluated by renal Doppler ultrasonography, which is thought to be a good indicator of renal vascular resistance. Subjects with higher variability in systolic blood pressure showed a significantly higher prevalence rate of clinical albuminuria and microalbuminuria, and showed significantly higher resistive index. Stepwise multiple regression analysis showed that variability in systolic blood pressure was a significant risk factor for higher resistive index, independent of other renal risk factors. Visit-to-visit variability in blood pressure correlates significantly with renal function and renal arteriosclerotic change. This parameter could provide additional information about renal arteriosclerotic change independent of estimated glomerular filtration rate and albuminuria, and should be considered a therapeutic target for renal protection.

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“…More recently, the renal resistive index (RI) calculated from pulsed Doppler flow at the interlobular arteries have been proposed for evaluating the renal microcirculation. [1][2][3] However, we still lack simple tools for evaluating the coronary and cerebral microcirculations. In this context, study of the cutaneous microcirculation has been the subject of numerous investigations.…”

Section: Introductionmentioning

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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The pulsatility index and the resistive index in renal arteries. Associations with long-term progression in chronic renal failure

Abstract: PI and RI correlated to the severity of the renal disease, as reflected by the rate of decline in reciprocal serum creatinine during antihypertensive treatment. The median RI or PI value could separate the patients into groups one of slow and another of fast progression.

Cited by 160 publications

References 12 publications

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

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

The impact of visit-to-visit variability in blood pressure on renal function

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

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