Clin Exp Nephrol

2018

DOI: 10.1007/s10157-018-1667-y

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Chronological renal resistive index increases related to atherosclerotic factors, and effect of renin-angiotensin system inhibitors

Yoshito Yamaguchi

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Cited by 6 publications

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“…Yamaguchi et al showed rapidly rising RI rate in diabetics regardless of the renal function as compared to non-diabetics, regardless of the albuminuria. In the presence of chronic kidney disease RI is higher in diabetics when compared to nondiabetics with the same level of renal dysfunction (33).…”

Section: Discussionmentioning

confidence: 92%

The renal resistive index as a new complementary tool to predict microvascular diabetic complications in children and adolescents: a groundbreaking finding

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et al. 2019

Ann. Transl. Med.

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The increasing prevalence of type 1 diabetes mellitus (DM) has made it necessary to have new markers for early detection of diabetic nephropathy. Renal resistive index (RI) by using renal Doppler can be a helpful tool in detecting functional alterations in renal hemodynamics. This study was conducted on 100 children and adolescents with type 1 DM. They were further subdivided into two equal subgroups: group 1 with type 1 DM and normo-albuminuria [urinary albumin excretion (UAE) <30 mg/24 hours], and group 2 with type 1 DM and hyper-albuminuria (increased UAE >30 mg/24 hours). There were 37 males (37%) and 63 females (63%); their mean ages were 13.6±2.53 (range, 10-19) years and mean disease duration was 8.867±2.260 (range, 5-13) years. Progressive increase in RI was significantly associated with increased disease duration more than 10 years, elevated serum HbA1c more than 7.5% and early pubertal stages. While not significantly related to sex, weight, height, blood pressure or serum lipid profile, diabetic micro-vascular complications (nephropathy and sensory neuropathy) were more prevalent among patients with RI more than 0.58. Renal RI could be a useful complementary test for the evaluation of functional alterations in renal hemodynamics in the early stages of diabetic nephropathy.

“…Yamaguchi et al showed rapidly rising RI rate in diabetics regardless of the renal function as compared to non-diabetics, regardless of the albuminuria. In the presence of chronic kidney disease RI is higher in diabetics when compared to nondiabetics with the same level of renal dysfunction (33).…”

Section: Discussionmentioning

confidence: 92%

The renal resistive index as a new complementary tool to predict microvascular diabetic complications in children and adolescents: a groundbreaking finding

¹

,

²

,

³

et al. 2019

Ann. Transl. Med.

View full text Add to dashboard Cite

The increasing prevalence of type 1 diabetes mellitus (DM) has made it necessary to have new markers for early detection of diabetic nephropathy. Renal resistive index (RI) by using renal Doppler can be a helpful tool in detecting functional alterations in renal hemodynamics. This study was conducted on 100 children and adolescents with type 1 DM. They were further subdivided into two equal subgroups: group 1 with type 1 DM and normo-albuminuria [urinary albumin excretion (UAE) <30 mg/24 hours], and group 2 with type 1 DM and hyper-albuminuria (increased UAE >30 mg/24 hours). There were 37 males (37%) and 63 females (63%); their mean ages were 13.6±2.53 (range, 10-19) years and mean disease duration was 8.867±2.260 (range, 5-13) years. Progressive increase in RI was significantly associated with increased disease duration more than 10 years, elevated serum HbA1c more than 7.5% and early pubertal stages. While not significantly related to sex, weight, height, blood pressure or serum lipid profile, diabetic micro-vascular complications (nephropathy and sensory neuropathy) were more prevalent among patients with RI more than 0.58. Renal RI could be a useful complementary test for the evaluation of functional alterations in renal hemodynamics in the early stages of diabetic nephropathy.

“…RRI is dependent on systemic hemodynamic factors [8][9][10][11][12][13][14][15] and varies with the heart rate. 16 A significant decrease in RRI was observed with an increasing heart rate.…”

Section: Discussionmentioning

confidence: 99%

“…The renal resistive index (RRI) has been demonstrated to predict not only the progression of renal disease but also the recurrence of cardiac major events in chronic kidney disease, coronary, and heart failure patients, in addition to frequently associated comorbidities such as hypertension, diabetes mellitus, and aging . Although diabetes mellitus is associated with alterations in global hemodynamic parameters (eg, increased central aortic pressure and pulse wave velocity) that are directly expected to modify RRI, the independent prognostic significance of diabetic‐related alterations in RRI remains to be investigated in primary prevention. Thus, we aimed to assess the prognostic significance of RRI regarding all‐cause death and major cardiovascular and renal events by exploring a cohort of patients with type 2 diabetes in primary prevention.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of the renal resistive index in the primary prevention of type II diabetes

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et al. 2020

J of Clinical Hypertension

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The renal resistive index has been demonstrated to predict the progression of renal disease and recurrence of major cardiac events in high‐risk cardiovascular patients, in addition to other comorbidities. We aimed to assess the prognostic significance of the renal resistive index in type 2 diabetic patients for primary prevention. From 2008 to 2011, patients with type 2 diabetes underwent cardiovascular evaluation, including renal resistive index assessment by renal Doppler ultrasound. The incidence of all‐cause death, cardiovascular events, dialysis requirement or a twofold increase in creatinine was recorded. Survival curves were estimated by the Kaplan‐Meier method. Two hundred sixty‐six patients were included; 50% of the patients were men, an HbA1C level of 8.1 ± 1.7% (65 ± 13.6 mmol/mol) and a serum creatinine level of 8 [7‐9] mg/L. The mean 24‐hour systolic blood pressure, 24‐hour diastolic blood pressure, and 24‐hour pulse pressure were 133.4 ± 16.7, 76.5 ± 9.4, and 56.9 ± 12.4 mm Hg, respectively. The median renal resistive index was 0.7 [0.6‐0.7] with a threshold of 0.7 predictive of monitored events. After adjustment of the 24‐hour pulse pressure, age and 24‐hour heart rate, a renal resistive index ≥0.70 remained associated with all‐cause death (hazard ratio: 3.23 (1.16‐8.98); P = .025) and the composite endpoint of major clinical events (hazard ratio: 2.37 (1.34‐4.18); P = .003). An elevated renal resistive index with a threshold of 0.7 is an independent predictor of a first cardiovascular or renal event in type 2 diabetic patients. This simple index should be implemented in the multiparametric staging of diabetes.

“…To our knowledge, only one study of Leoncini et al (24) found significant decrease of RRI in few patients treated with ACE inhibitor (lisinopril) compared to others treated with CCB (nifedipine), which indicated more renal protective effect of ACE/ARBs than other antihypertensive drugs. Yamaguchi et al (25) , by studying RRI in patients with chronic kidney disease (CKD), found negative association between RRI and use of rennin-angiotensin system inhibitors (RAS-I), and they concluded that "RAS-Is could contribute towards suppressing the elevation of RI in CKD patients and towards preventing the development of renal failure in CKD patients".…”

Section: Discussionmentioning

confidence: 99%

Renal Resistive Index as An Indicator of Atherosclerotic Changes and Renal Damage in Hypertension and Its Role in Therapeutic Intervention

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Renal resistive index (RRI) was suggested as an indicator of renal atherosclerotic changes in hypertensive patients with possible prognostic role in treatment.Objectives: This study aimed to assess RRI in hypertensive subjects, its relation to other predictors of target organ damage and prognostic usefulness in management, specifically, with different antihypertensive drugs. Patients and methods:The study included 100 newly diagnosed hypertensive adult subjects, who underwent abdominal ultrasound with Doppler to assess RRI, which was correlated with their clinical parameters including estimated glomerular filtration rate (eGFR) and other subclinical atherosclerosis markers as carotid intima-media thickness (IMT) and aortic knob width (AKW) calculated from chest radiograph. Another 50 non hypertensive subjects were assessed for their RRI as a control group. In addition, some of hypertensive patients were followed up one year after starting treatment was done and effects of different antihypertensive agents on their RRI were compared. Results:The mean baseline RRI in hypertensive patients (0.71 ± 0.04) was significantly higher compared to control group (0.60 ± 0.02) and was positively significantly correlated with their clinical parameters (age, systolic, diastolic, pulse pressure and eGFR) and with their atherosclerotic parameters (IMT and AKW). In addition, ACE/ARBs treatment was associated with significant decrease of RRI compared to other drugs [beta blocker (BB) and calcium channel blocker (CCB)], indicating their more renal protective effect. Conclusion: Assessment of RRI in patients with primary hypertension not only reflecting intrarenal perfusion changes, but it indicates systemic atherosclerotic changes, so it can be useful as prognostic parameter in addition to its possible therapeutic implications.

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