The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients

Abstract

To evaluate the significance of the renal resistive index (RI) as a noninvasive marker of renal histological damage and a prognostic indicator, we examined RI by Doppler ultrasonography in 202 chronic kidney disease (CKD) patients who underwent renal biopsy. RI increased as the CKD stage progressed and correlated with age, systolic blood pressure, estimated glomerular filtration rate (eGFR), and renal histological changes, including glomerulosclerosis, arteriolosclerosis, and tubulointerstitial damage. Prognostic evaluation with a median follow-up period of 38.5 months revealed that patients with RI ≥ 0.7 (high RI group, n = 39) had significantly poorer renal survival than those with RI < 0.65 (normal RI group, n = 120) and 0.65 ≤ RI < 0.7 (high-normal RI group, n = 43). The patients in the high-normal RI group showed good response to steroids. However, in the high RI group, steroid therapy did not significantly improve renal survival. Of the clinical indices studied, RI ≥ 0.7, hypertension, proteinuria, and low eGFR at diagnosis were independent risk factors for worsening renal dysfunction. In conclusion, RI in CKD patients was considered as a marker of renal function, histological damage, and renal prognosis, and a possible determinant of indication for steroids.

Doppler ultrasound in kidney diseases: a key parameter in clinical long-term follow-up

“…In fact Patients with higher RRI ([0.7) generally show more severe arteriolosclerosis than others with normal (\0.65) or high normal RRI (0.65 B RI \ 0.7) [17]. Patients with High-Normal RRI showed good response to steroid therapy versus those with a RRI [0.7 [16], so it could be an useful tool to predict response to steroid therapy.…”

“…RRI has shown to be related with glomerulosclerosis, arteriolosclerosis and tubulointerstitial lesions more than others morphologic parameters like renal length and cortex area [16]. In fact Patients with higher RRI ([0.7) generally show more severe arteriolosclerosis than others with normal (\0.65) or high normal RRI (0.65 B RI \ 0.7) [17].…”

Retrospective Study of Renal Artery Doppler evaluation of Hypertensive patients

“…7 Intra renal resistance index has been correlated with the arteriolar resistance and thus increase in resistance index correlates well with progression of renal disease and so does persistent hypertension. [5][6][7][8] In our study the most common abnormality was the raised resistance index, alone which indicates that these patients had medical nephropathy. The prevalence of nephropathy among all patients evaluated with Doppler examination was high 18.7%.…”

“…1,4 Apart renal Doppler can also predict usefulness of revascularization procedure and is also useful in primary hypertensive. [4][5][6][7] This study aims to evaluate the abnormalities in Renal Doppler examination performed for evaluation of atypical hypertensive patients suspicious of renal artery stenosis.…”

Assessment of Sitagliptin Influence on Arterial Wall Stiffness, Renal Function and Renal Circulation in Cardiovscular Patients With Decompensated Type 2 Diabetes

“…Наиболее ранним при-знаком поражения сосудов почек при СД-2 является увеличение резистивного индекса (РИ) почечных артерий по данным ультразвукового дуплексного ска-нирования. Повышение РИ наблюдается ещё до появ-ления микроальбуминурии и связано с неблагоприят-ным прогнозом при СД-2 [5,6].…”