Renal haemodynamics and severity of carotid atherosclerosis in hypertensive patients with and without impaired renal function

Geraci, Giulio; Mulè, Giuseppe; Mogavero, Manuela; Geraci, Calogero; D'Ignoti, D.; Guglielmo, Chiara; Cottone, Santina

doi:10.1016/j.numecd.2014.10.008

Cited by 35 publications

(31 citation statements)

References 30 publications

(35 reference statements)

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“…In the same study population we observe increased values of RRI in subjects with greater severity of carotid atherosclerosis (Fig. 1b), and a strong correlation between RRI and carotid intima-media thickness (cIMT) [8]. Similar results are found in a smaller group of normotensive subjects with systemic erythematosus lupus and in different clinical contexts [2,5,6,9].…”

supporting

confidence: 79%

“…It is suggested that this index directly reflects intrarenal vascular resistance, which results in its denomination as 'resistance index'. However, accumulating evidence indicates that the RRI provides important information about the systemic vasculature as well [2,[5][6][7][8][9][10]. Indeed, recent data suggest that this parameter is not only an expression of parenchymal perfusion, but may also be influenced by upstream vascular factors, and indeed these factors appear to play a more important role than intrarenal resistance [2,[5][6][7][8][9][10].…”

mentioning

confidence: 99%

“…1 a Mean values (±SD) of renal resistive index in hypertensive patients with aortic pulse wave velocity (aPWV) greater and lower than 10 m/s, a cut-off value able to detect subjects with an enhanced cardiovascular risk [7]. b Mean values (±SD) of renal resistive index in hypertensive patients with normal carotid intima-media thickness (cIMT), with increased cIMT and with carotid plaques [8] Intern Emerg Med…”

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confidence: 99%

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The renal resistive index: is it a misnomer?

Mulè

Geraci

et al. 2015

Intern Emerg Med

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Progress in digital ultrasound technology and diffusion of\ud Doppler ultrasound evaluation of the kidney enable a\ud widespread non-invasive evaluation of renal haemodynamics.\ud Initially most attention has been paid to the study\ud of extraparenchymal renal arteries, mainly to detect renovascular\ud disease. However, this approach has low reproducibility\ud and accuracy. Therefore, interest has gradually\ud moved towards the duplex evaluation of intrarenal anatomy,\ud where the best and most reliable signals are obtained\ud from the large segmental or interlobar arteries that run\ud directly towards the transducer.\ud Among the sonographic parameters used in the last\ud decade, great emphasis has been placed on the intrarenal\ud resistive index (RRI), which is defined as the dimensionless\ud ratio of the difference between maximum and minimum\ud (end-diastolic) flow velocity to maximum flow velocity.\ud It has been used for a long time for the diagnostic and\ud prognostic assessment of renovascular disease . One\ud of the earliest prospective uses of the RRI was in the\ud prediction of kidney function outcomes following intervention\ud for renal artery stenosis. In the pioneering study of\ud Radermacher et al., an RRI[0.80 is associated with poorer\ud outcomes, when surgery or angioplasty is used to correct\ud renal artery stenosis ..

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confidence: 79%

mentioning

confidence: 99%

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confidence: 99%

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The renal resistive index: is it a misnomer?

Mulè

Geraci

et al. 2015

Intern Emerg Med

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“…In patients with renal cysts, RRI was determined as the average of at least four measurements performed in renal areas far from the cysts. The Doppler angle chosen was less than 60°, and special care was taken not to compress the kidney and not to have the patient perform a Valsalva maneuver, because both can increase the RRI …”

Section: Methodsmentioning

confidence: 99%

Association Between Uric Acid and Renal Hemodynamics: Pathophysiological Implications for Renal Damage in Hypertensive Patients

Geraci

Mulè

Mogavero

et al. 2016

J of Clinical Hypertension

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The role of vascular renal changes in mediating the association between serum uric acid (SUA) and renal damage is unclear. The purposes of this study were to investigate the relationship between SUA and renal resistive index (RRI), assessed by duplex Doppler ultrasonography, and to assess whether hemodynamic renal changes may explain the association between SUA and renal damage in hypertensive patients. A total of 530 hypertensive patients with and without chronic kidney disease were enrolled and divided into SUA tertiles based on sex-specific cutoff values. RRI and albuminuria were greater and glomerular filtration rate (GFR) was lower in the uppermost SUA tertile patients when compared with those in the lowest tertiles (all P<.001). Moreover, SUA strongly correlated with RRI (P<.001) in all patients. However, RRI did not seem to explain the relationship between SUA and renal damage, and GFR significantly related with SUA in the overall population (P<.001) even after adjustment for RRI.

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“…27 In the same lines, an increased RRI in essential HTN has been associated with increased central pulse pressure and aortic pulse wave velocity, ambulatory arterial stiffness index, and nondipping profile. 27 In the same lines, an increased RRI in essential HTN has been associated with increased central pulse pressure and aortic pulse wave velocity, ambulatory arterial stiffness index, and nondipping profile.…”

Section: Rri and Targ E T Org An Damag E In E Ss Ential Htnmentioning

confidence: 93%

Renal resistive index in hypertensive patients

Andrikou

Tsioufis

Konstantinidis

et al. 2018

J of Clinical Hypertension

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Spectral Doppler ultrasonography provides the evaluation of renal resistive index (RRI), a noninvasive and reproducible measure to investigate arterial compliance and/or resistance. RRI seems to possess an important role in the evaluation of diverse cases of secondary hypertension. In essential hypertension, RRI is associated with subclinical markers of target organ damage and reflects renal disease progression beyond albuminuria and creatinine clearance. Also, RRI can estimate cardiovascular and renal risk. The evaluation of RRI may also help the therapeutic decisions. Given its simple assessment, RRI emerges as a simple method and a “multifunctional” tool that could help on the cardiovascular risk evaluation of the hypertensive patient.

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Renal haemodynamics and severity of carotid atherosclerosis in hypertensive patients with and without impaired renal function

Cited by 35 publications

References 30 publications

The renal resistive index: is it a misnomer?

The renal resistive index: is it a misnomer?

Association Between Uric Acid and Renal Hemodynamics: Pathophysiological Implications for Renal Damage in Hypertensive Patients

Renal resistive index in hypertensive patients

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