Dang Wantai, Luo Hui, Hu Jin, Liu Jian
Department of Rheumatism and Immunity, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
Department of Ultrasound, The First People's Hospital of Longquanyi District, Chengdu, Sichuan, China.
Rheumatol Adv Pract. 2024 Aug 9;8(4):rkae094. doi: 10.1093/rap/rkae094. eCollection 2024.
Gout may disturb renal hemodynamics by promoting uric acid deposition; however, this relationship has not been elucidated with adequate clinical evidence. In this study, we measured the renal artery resistance index (ARI) in patients with gout to identify the risk factors and establish predictive models for elevated renal ARI in these patients.
Renal artery ultrasound examination was performed in 235 primary gout patients and 50 healthy controls (HCs); subsequently, their renal interlobar ARI (RIARI), renal segmental ARI (RSARI) and overall intrarenal ARI (OIARI) were recorded. Each ARI > 0.7 was considered elevated.
RIARI, RSARI and OIARI were higher in patients with gout than in HCs (all <0.001). Nineteen (8.1%), 24 (10.2%) and 18 (7.7%) patients had elevated RIARI, RSARI and OIARI scores, respectively. Multivariate logistic regression analyses disclosed that: age ≥ 60 years (=0.000), abnormal beta2 microglobulin (βMG) (=0.028), and abnormal high-density lipoprotein cholesterol (HDLC) (=0.030) were independently associated with elevated RIARI; age ≥ 60 years (=0.000), and abnormal βMG (=0.013) were independently related to elevated RSARI; abnormal total protein (TP) (=0.014) were independently linked with elevated OIARI in gout patients. Consequently, predictive models for elevated ARI were established using nomograms based on the aforementioned independent risk factors, which showed a satisfactory value for estimating elevated RIARI [area under the curve (AUC):0.929], RSARI (AUC: 0.926) and OIARI (AUC: 0.660) in patients with gout, as validated by receiver operating characteristic curves.
Renal ARI were elevated in patients with gout, whose independent risk factors included older age and abnormal βMG, HDLC and TP levels.
痛风可能通过促进尿酸沉积干扰肾脏血流动力学；然而，这种关系尚未得到充分的临床证据阐明。在本研究中，我们测量了痛风患者的肾动脉阻力指数（ARI），以确定危险因素并建立这些患者肾动脉ARI升高的预测模型。
对235例原发性痛风患者和50例健康对照者（HCs）进行肾动脉超声检查；随后，记录他们的肾叶间ARI（RIARI）、肾段ARI（RSARI）和肾内总体ARI（OIARI）。每个ARI>0.7被认为升高。
痛风患者的RIARI、RSARI和OIARI高于HCs（均<0.001）。分别有19例（8.1%）、24例（10.2%）和18例（7.7%）患者的RIARI、RSARI和OIARI评分升高。多因素逻辑回归分析显示：年龄≥60岁（=0.000）、β2微球蛋白（βMG）异常（=0.028）和高密度脂蛋白胆固醇（HDLC）异常（=0.030）与RIARI升高独立相关；年龄≥60岁（=0.000）和βMG异常（=0.013）与RSARI升高独立相关；总蛋白（TP）异常（=0.014）与痛风患者的OIARI升高独立相关。因此，基于上述独立危险因素使用列线图建立了ARI升高的预测模型，经受试者工作特征曲线验证，该模型在估计痛风患者RIARI升高[曲线下面积（AUC）：0.929]、RSARI升高（AUC：0.926）和OIARI升高（AUC：0.660）方面显示出令人满意的价值。
痛风患者的肾动脉ARI升高，其独立危险因素包括年龄较大以及βMG、HDLC和TP水平异常。
