Comparison of renal arterial resistive index in type 2 diabetic nephropathy stage 0-4

Abstract

Chronic kidney disease (CKD) is one of world health problems and its prevalence and incidence is increasing. Chronic Kidney Failure involves a range of pathophysiologic processes that are associated with impaired renal function, leading to cardiovascular morbidity and mortality. Renal artery resistive index (RI) is indicator of atherosclerotic change in small vessels. The current study was aimed to assess RI in diabetic nephropathy patients at stage 0-4 and to compare RRI with HbA1c, systolic blood pressure, diastolic blood pressure, albuminuria and glomerular filtration rate (GFR). In this cross sectional study,100 diabetic nephropathy patients who attend to nephrology clinic of Ali-ibn Abi Talib Hospital were entered to the study. Ultrasound Doppler renal resistive index was measured and other information was recorded from their last lab data that was recorded in their medical records. Variable included: systolic blood pressure, diastolic blood pressure, albuminuria, GFR, HbA1c. All data was analyzed by Pearson's Correlation Coefficient. The findings indicated a significant correlation of RI with systolic BP (p=0.04 R=0.75), microalbuminuria (P=0.001 R=0.67), and GFR (P=0.001 R=0.76), while diastolic BP (P=0/45 R=0/32), HbA1c (P=0/56 R=0/43) were not found to be associated with RI. The findings indicated that increased systolic blood pressure, albumin excretion (microalbuminuria) and severity of disease were capable of increasing RI values in diabetic nephropathy patients. In addition, decreased GFR.

Association of renal resistive indices with kidney disease progression and mortality

“…recently demonstrated that patients with CKD have an increased intrarenal pulsatility and an elevated RRI [ 30 ]. Sistani et al showed significant association between RRI and GFR and albuminuria among 100 patients with diabetic nephropathy [ 31 ]. Bigé et al evaluated RRI levels in 58 patients two days prior to kidney biopsy and found a strong correlation between RRI and interstitial fibrosis as well as accelerated kidney function decline independent of baseline eGFR [ 32 ].…”

Exosomes and ultrasound: The future of theranostic applications

“…Certain conditions like secondary nephropathies accompanied with glomerular damage, shows RI more than 0.75 to 0.8 because of the co-existing microvascular impairment due to vasculitis, glomerulo/lupus nephritis [ 307 ]. On the other hand, the diabetic nephropathy (DN) with characterized microalbuminuria, hyperfiltration and uncontrolled glycosylated hemoglobin was detected with low RI (∼0.5) and high GFR [ 227 ]. But, in later stages of DN the RI significantly increases due to microvascular injury and reduction in GFR [ 228 ].…”