Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
Department of Nephrology, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
BMC Nephrol. 2023 Nov 28;24(1):348. doi: 10.1186/s12882-023-03398-6.
Renal resistive indices (RRI) have been shown to predict the progression of kidney disease. This study aims to evaluate the association of RRI with mortality and dialysis initiation after adjustment to therapeutic and life style interventions.
This is a retrospective study that included all chronic kidney disease patients followed for at least two years in three nephrology clinics between 2006 and 2019 and who had a RRI level in their files. Kaplan Meier and log rank test compared the survival of patients with normal versus high RRI. Cox regression analysis evaluated the association between RRI and death or dialysis initiation after adjustment to treatments and life style modifications.
A total of 192 patients were analyzed: 68 had RRI < 0.7 and 124 had RRI ≥ 0.7. Their mean age was 66.5 ± 13.1 years at first visit, 78.1% were males. There was a negative correlation between baseline eGFR and RRI (p < 0.001; Spearman correlation coefficient = -0.521). The survival was significantly better in patients with RRI < 0.7 with a Log Rank test < 0.001. The univariate cox regression analysis showed a significant association between RRI and mortality (HR = 1.08; 95%CI: 1.04-1.11; p < 0.001) that remained significant after adjustment to cardiovascular risk factors and interventions such as salt reduction, blood pressure control, statins and RAAS inhibitors (HR = 1.04; 95%CI: 1.00-1.08; p = 0.036). Cox regression analysis showed a significant association between RRI and dialysis initiation (HR = 1.06; 95%CI 1.01-1.10; p = 0.011).
Our study revealed that patients with an elevated RRI ≥ 0.7 are at a higher risk of mortality after adjustment to medications and lifestyle modifications. RRI can, according to this study, be considered as an independent prognostic factor in CKD patients.
肾血管阻力指数（RRI）已被证明可预测肾脏病的进展。本研究旨在评估 RRI 与接受治疗和生活方式干预后的死亡率和透析开始的关系。
这是一项回顾性研究，纳入了 2006 年至 2019 年在三个肾病诊所至少随访两年且档案中有 RRI 水平的所有慢性肾脏病患者。Kaplan-Meier 和对数秩检验比较了 RRI 正常与升高患者的生存情况。Cox 回归分析评估了 RRI 与调整治疗和生活方式改变后死亡或透析开始的关系。
共分析了 192 例患者：68 例 RRI<0.7，124 例 RRI≥0.7。首次就诊时的平均年龄为 66.5±13.1 岁，78.1%为男性。基线 eGFR 与 RRI 呈负相关（p<0.001；Spearman 相关系数=-0.521）。RRI<0.7 的患者生存明显更好，Log Rank 检验<0.001。单因素 Cox 回归分析显示，RRI 与死亡率显著相关（HR=1.08；95%CI：1.04-1.11；p<0.001），调整心血管危险因素和干预措施（如减少盐摄入、控制血压、他汀类药物和 RAAS 抑制剂）后仍有显著相关性（HR=1.04；95%CI：1.00-1.08；p=0.036）。Cox 回归分析显示，RRI 与透析开始显著相关（HR=1.06；95%CI 1.01-1.10；p=0.011）。
本研究表明，调整药物和生活方式改变后，RRI 升高（≥0.7）的患者死亡率更高。根据本研究，RRI 可被视为 CKD 患者的独立预后因素。
