Renal Resistance Index and Progression of Renal Disease

Radermacher, Jörg; Ellis, S.; Haller, Hermann

doi:10.1161/hy0202.103782

Cited by 218 publications

(178 citation statements)

References 15 publications

Supporting

Mentioning

168

Contrasting

Unclassified

Order By: Relevance

“…Previous studies revealed that the RI was a useful predictor of renal dysfunctions [11][12][13][14][15][16] and correlated significantly with organ damage. Measurement of RI in addition to low-grade albuminuria is reportedly useful for target organ damage screening in patients with resistant Blood pressure variability and renal function T Kawai et al hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15][16] We previously reported that the RI might be a more efficacious parameter for the evaluation of very early renal damage than estimated glomerular filtration rate (eGFR). 17 It is thought that renal vascular damage caused by atherosclerotic risk factors such as hypertension and variability of BP could be evaluated more precisely by the RI.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of visit-to-visit variability in blood pressure on renal function

et al. 2011

View full text Add to dashboard Cite

Hypertension is an important risk factor for cardiovascular diseases such as chronic kidney disease. It is still not fully understood how blood pressure impacts the kidneys. In this study, we aimed to establish the significance of visit-to-visit variability in blood pressure for renal function. We analyzed 143 consecutive patients undergoing renal Doppler ultrasonography in our hospital ward and measured blood pressure at outpatient visits six or more times. We analyzed the correlation between visit-to-visit variability in blood pressure and multiple clinical parameters, including albuminuria and resistive index evaluated by renal Doppler ultrasonography, which is thought to be a good indicator of renal vascular resistance. Subjects with higher variability in systolic blood pressure showed a significantly higher prevalence rate of clinical albuminuria and microalbuminuria, and showed significantly higher resistive index. Stepwise multiple regression analysis showed that variability in systolic blood pressure was a significant risk factor for higher resistive index, independent of other renal risk factors. Visit-to-visit variability in blood pressure correlates significantly with renal function and renal arteriosclerotic change. This parameter could provide additional information about renal arteriosclerotic change independent of estimated glomerular filtration rate and albuminuria, and should be considered a therapeutic target for renal protection.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of visit-to-visit variability in blood pressure on renal function

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Although RRI may not be useful in the differential diagnosis of intrinsic renal disease because it does not differ in the various types of renal parenchymal diseases. 24 It is also well known that high RRI values are associated with poor renal prognosis; recently, Radermacher et al, 8 showed that a very high RRI of at least 80 or higher reliably identifies hypertensive patients, without renal artery stenosis, at risk for progressive renal disease. 8 It is unclear whether this indicates irreversible renal scarring or whether a therapeutic strategy could favourably influence the prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…24 It is also well known that high RRI values are associated with poor renal prognosis; recently, Radermacher et al, 8 showed that a very high RRI of at least 80 or higher reliably identifies hypertensive patients, without renal artery stenosis, at risk for progressive renal disease. 8 It is unclear whether this indicates irreversible renal scarring or whether a therapeutic strategy could favourably influence the prognosis. 8 Other studies reported that RRI was positively correlated with IMT, albumin-to-creatinine ratio, macroangiopathy and carotid arteriosclerosis.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Increased renal vascular resistance has recently been associated with the severity and duration of essential hypertension and with declining renal function in renal parenchymal disease. 8 Previous studies have shown that the renal resistive index (RRI) is an indicator of renal vascular resistance in essential hypertension. 9 Determining RRI is inexpensive (the same probe is used for the heart), fast (it takes a minute to perform) and requires little training (less than 1 month).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Renal resistive index and cardiovascular organ damage in a large population of hypertensive patients

et al. 2007

View full text Add to dashboard Cite

We evaluated the relationship between renal resistive index (RRI) of the intrarenal vasculature and cardiovascular (CV) organ damage such as left ventricular hypertrophy (LVH), diastolic dysfunction and carotid atherosclerosis in a large sample of hypertensive patients. 566 hypertensive patients underwent echocardiography with conventional Doppler and Doppler tissue imaging (DTI), carotid and renal ultrasonography. In addition, lipids profile, creatinine in serum, and urinary albumin concentrations were determined. The patients were divided according to their RRI values in 2 groups: o70 and X70. Subjects with high RRI were older, had higher systolic and pulse pressure (PP) and more years of hypertension, compared to those with low RRI (Po0.0001). Patients with the higher RRI showed an increased left ventricular mass index (LVMI) and carotid intima-media thickness (IMT) with a higher prevalence of LVH, carotid plaques and microalbuminuria (Po0.001). There were differences in overall diastolic parameters, in particular when evaluated by DTI (Po0.001). A positive correlation was found between RRI and age, PP, carotid IMT, LVMI, SBP and a negative correlation was found with DTI diastolic parameters (Po0.001). Age, PP, carotid IMT and LVMI were independently related to RRI. While, RRI was independently related to IMT and IVRT. RRI, especially the higher values, are positively correlated with target organ damage in hypertensive patients, indicating that renal vascular resistance is related to morphologic and hemodynamic alteration of the CV system. The evaluation of RRI could predict the presence of early CV damage and provide an accurate estimate of overall risk.

show abstract

The renal arterial resistance index: a marker of renal function with an independent and incremental role in predicting heart failure progression

Ciccone

Iacoviello

Gesualdo

et al. 2013

European J of Heart Fail

View full text Add to dashboard Cite

AimsThe renal arterial resistance index (RRI) is a measure of renal blood flow obtained by Doppler ultrasonography, which has been demonstrated to reflect both vascular and parenchymal renal abnormalities. The aim of the study was to evaluate clinical correlates and the prognostic relevance of RRI in a group of patients affected by chronic heart failure (CHF Methods and resultsWe enrolled 250 CHF outpatients in a stable clinical condition and receiving conventional therapy. Peak systolic velocity and end-diastolic velocity of a segmental renal artery were obtained by pulsed Doppler flow. Then the RRI was calculated. Standard renal function assessment was obtained by the measurement of creatinine serum levels and the estimation of the glomerular filtration rate (GFR). During follow-up (21.4 ± 11.3 months), 41 patients experienced heart failure progression (hospitalization and/or heart transplantation and/or death due to worsening heart failure). Considered as a continuous variable, RRI was associated with events at univariate [hazard ratio (HR) 1.14; 95% confidence interval (CI) 1.09-1.19; P < 0.001] as well as at multivariate Cox regression analysis (HR 1.08; 95% CI 1.02-1.13; P = 0.004) after correction for independent predictors of the reference model. When the RRI was added to the reference model including GFR, a significant improvement of reclassification according to both category-free net reclassification improvement (NRI, 47%; 95% CI 13-80%; P = 0.006) and integrated discrimination improvement (IDI, 0.034; 95% CI 0.006-0.061; P = 0.016) was observed.

show abstract

Renal Resistance Index and Progression of Renal Disease

Cited by 218 publications

References 15 publications

The impact of visit-to-visit variability in blood pressure on renal function

The impact of visit-to-visit variability in blood pressure on renal function

Renal resistive index and cardiovascular organ damage in a large population of hypertensive patients

The renal arterial resistance index: a marker of renal function with an independent and incremental role in predicting heart failure progression

Contact Info

Product

Resources

About