Department of Internal Diseases, Nephrology, and Dialysis, Military Institute of Medicine, Warsaw 44, Poland.
Biomed Res Int. 2013;2013:137868. doi: 10.1155/2013/137868. Epub 2013 Jun 18.
Properly preserved renal perfusion is the basic determinant of oxygenation, vitality, nutrition, and organ function and its structure. Perfusion disorders are functional changes and are ahead of the appearance of biochemical markers of organ damage. The aim of this study was to evaluate a relationship between the renal cortex perfusion and markers of cardiovascular organ damage in patients with stable chronic renal failure (CKD).
Seventeen patients (2 F; 15 M; age 47 ± 16) with stable CKD at 2-4 stages and hypertension or signs of heart failure were enrolled in this study. Blood tests with an estimation of renal and cardiac functions, echocardiographic parameters, intima-media thickness (IMT), renal resistance index (RRI), and total (TPI), proximal (PPI), and distal (DPI) renal cortical perfusion intensity measurements were collected.
DPI was significantly lower than PPI. TPI significantly correlated with age, Cys, CKD-EPI (cystatin), and IMT, whereas DPI significantly depended on Cystain, CKD-EPI (cystatin; cystatin-creatinine), IMT, NT-proBNP, and troponin I. In multiple stepwise regression analysis model only CKD-EPI (cystatin) independently influenced DPI.
Cardiovascular and kidney damage significantly influences renal cortical perfusion. Ultrasound measurement of renal perfusion could be a sensitive method for early investigation of cardiovascular and renal injuries.
适当的肾脏灌注是氧合、活力、营养和器官功能及其结构的基本决定因素。灌注障碍是功能性变化，先于器官损伤的生化标志物出现。本研究旨在评估稳定慢性肾衰竭（CKD）患者的肾脏皮质灌注与心血管器官损伤标志物之间的关系。
本研究纳入了 17 名患有稳定 CKD 2-4 期的高血压或心力衰竭迹象的患者（2 名女性；15 名男性；年龄 47 ± 16 岁）。收集了血液检查结果，包括肾功能和心脏功能评估、超声心动图参数、内膜中层厚度（IMT）、肾阻力指数（RRI）以及总（TPI）、近端（PPI）和远端（DPI）肾脏皮质灌注强度测量值。
DPI 显著低于 PPI。TPI 与年龄、Cys、CKD-EPI（半胱氨酸蛋白酶抑制剂）和 IMT 显著相关，而 DPI 则显著依赖于胱抑素、CKD-EPI（半胱氨酸蛋白酶抑制剂；胱抑素-C）、IMT、NT-proBNP 和肌钙蛋白 I。在多元逐步回归分析模型中，只有 CKD-EPI（胱抑素）独立影响 DPI。
心血管和肾脏损伤显著影响肾脏皮质灌注。肾脏灌注的超声测量可能是早期检测心血管和肾脏损伤的敏感方法。
