Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis: a monocentric observational study

Cardiovascular Ultrasound

Research

Irene Di Paco¹  Caterina Romanini¹  Lorenzo Ghiadoni¹  Melania Sgrò¹  Elena Daghini¹  Stefano Taddei¹  Michela Sanna¹  Daniele Versari¹  Luigi Venturini¹  Stefania Pinto¹  Rosa Maria Bruno²  Lilach O Lerman³  Roberto Cioni⁴  Isabella Sudano⁵ 

[1] Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;Institute of Clinical Physiology – CNR, Via Moruzzi 1, 56124, Pisa, Italy;Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA;Department of Interventional Radiology, University Hospital of Pisa, Pisa, Italy;University Heart Center, University Hospital Zurich, Zurich, Switzerland;

关键词: Resistive index;    Ultrasound;    Renal artery stenosis;    Hypertension;    Revascularization;   

DOI  :  10.1186/1476-7120-12-9

 received in 2014-01-15, accepted in 2014-02-13,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe present study evaluated the predictive value of renal resistive index (RI) for renal function and blood pressure (BP) outcome in hypertensive patients with unilateral atherosclerotic renal artery stenosis submitted to successful revascularization.MethodsIn 158 hypertensive patients with atherosclerotic renal artery stenosis RI was acquired. Twelve months after revascularization, they were classified on the basis of renal function and BP outcome as benefit (BP < 140/90 mmHg or diastolic BP reduction > 15 mmHg with the same of reduced drugs; decrease in glomerular filtration rate > 20%), or failure.ResultsRegarding renal function outcome, RI in the stenotic and in the contralateral kidney were significantly higher in patients with failure (n = 20) than in those with benefit (0.72 ± 0.11 vs 0.61 ± 0.11 and 0.76 ± 0.08 vs 0.66 ± 0.09, p < 0.05). Among different cutpoints generated, RI in the contralateral kidney >0.73 provided the largest area under the curve (0.77), and the highest sensitivity (80%) and specificity (72%). In the multivariate logistic regression analysis, RI in the contralateral kidney >0.73 was an independent predictor of a failure in renal function outcome.Regarding BP outcome, patients with no benefit from revascularization (n = 60) had similar RI in the stenotic and contralateral kidney (p = ns), but presented higher pulse pressure, albuminuria and hypertension duration in comparison to patients with improved BP control.ConclusionsRI in the contralateral kidney is an independent predictor of renal function outcome after successful revascularization in hypertensive patients with unilateral atherosclerotic renal artery stenosis, whereas it is not able to predict blood pressure outcome.

【 授权许可】

CC BY   
© Bruno et al.; licensee BioMed Central Ltd. 2014