在耐药性高血压患者中，肾动脉阻力指数（RRI）与肾脏结局之间的关系。

The Relationship Between Renal Arterial Resistive Index (RRI) and Renal Outcomes in Patients with Resistant Hypertension.

机构信息

Department of Nephrology, Clinical Research Development Unit (CRDU), Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran.

出版信息

Iran J Kidney Dis. 2020 Dec;14(6):448-453.

PMID:33277448

Abstract

INTRODUCTION

There is a mutual relationship between hypertension and renal failure, so that hypertension can be considered as a common finding in patients with end-stage renal disorders. Patients with persistent hypertension despite multiple medications are at high risk for adverse cardiovascular and kidney events. Some studies suggest that there is a correlation between RI and renal function in kidney diseases. Therefore, we conducted a study to investigate the relationship between renal arterial resistive index (RRI) and renal outcomes in patients with resistant hypertension.

METHODS

This 2-years cross-sectional study was performed on patients with resistant hypertension. All patients undergo GFR, serum Cr and urine Alb tests. Then Doppler ultrasound was performed by a radiologist to measure RRI and was evaluated for the relationship between RRI and renal function.

RESULTS

Among 133 patients with resistant hypertension, 57.5% were male and the rest were female. Average age of participants and average RI were 48.26 ± 16.90 and 0.63 ± 0.80, respectively. There was no significant relationship between RI and gender (P > .05). Relationship between RI index with age, GFR, serum creatinine level, and albuminuria was significant in all cases (P < .05). Patients were divided into two groups with RI ≥ 0.7 and RI less than 0.7. Results showed a significant increase in serum creatinine and urinary albumin excretion in group with RI ≥ 0.7 (P < .05), while age, protein exertion level, and GFR in the two groups were not statistically significant (P > .05), despite the difference in the mean. Results of analysis of difference in the mean RI in 3 groups (macro-, micro-, normo- albuminuria) showed no significant difference between them (P > .05).

CONCLUSION

These data demonstrate the clinical importance of renal Doppler that may be an effective way to evaluate the prognosis of renal involvement in resistant hypertension.

摘要

简介

高血压和肾衰竭之间存在相互关系，因此高血压可以被认为是终末期肾脏疾病患者的常见表现。尽管使用了多种药物，但仍持续存在高血压的患者发生不良心血管和肾脏事件的风险很高。一些研究表明，在肾脏疾病中，RI 与肾功能之间存在相关性。因此，我们进行了一项研究，旨在调查难治性高血压患者的肾动脉阻力指数（RRI）与肾脏结局之间的关系。

方法

这是一项为期 2 年的横断面研究，纳入了难治性高血压患者。所有患者均接受 GFR、血清 Cr 和尿 Alb 检测。然后由放射科医生进行多普勒超声检查，以测量 RRI，并评估 RRI 与肾功能之间的关系。

结果

在 133 例难治性高血压患者中，57.5%为男性，其余为女性。参与者的平均年龄和平均 RI 分别为 48.26 ± 16.90 和 0.63 ± 0.80。RI 与性别之间无显著关系（P >.05）。在所有情况下，RI 指数与年龄、GFR、血清肌酐水平和蛋白尿均呈显著相关（P <.05）。将患者分为 RI≥0.7 和 RI<0.7 两组。结果显示，RI≥0.7 组的血清肌酐和尿白蛋白排泄量显著增加（P <.05），而两组的年龄、蛋白排泄水平和 GFR 无统计学差异（P >.05），尽管平均值有所不同。对 3 组（大量、微量、正常白蛋白尿）中 RI 均值差异的分析结果表明，它们之间无显著差异（P >.05）。