The Evaluation of Renal Hemodynamics with Doppler Ultrasonography

Kaya, Mükerrem

doi:10.5772/36263

Cited by 9 publications

(15 citation statements)

References 126 publications

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“…32 While current Bayesian approaches to screening for risk of preeclampsia factor in sonographic vascular bed assessment, 33 16,17 Renal hyperfiltration is often defined only by laboratory assessment, but multimodal assessment offers further insight into the mechanism behind those values. Renal Doppler assessment is well described in the renal, lobar, and arcuate arteries, 18,21 and mean renal artery resistance index (0.64) is as would be expected. Assessment of the cortical vessels was based on the suspicion that small vessel vascular beds would show prepathologic changes in renal vascular resistance earlier than large ones and that resistance patterns in the arteries within the cortical region of the kidney would be most sensitive to small vessel disease.…”

Section: Discussionsupporting

confidence: 54%

“…Ultrasound indices of renal vascular resistance were assessed according to previously described methods . In brief, with subjects in supine position, a single expert operator (I.B.)…”

Section: Methodsmentioning

confidence: 99%

“…Ultrasound indices of renal vascular resistance were assessed according to previously described methods. [18][19][20]…”

Section: Methodsmentioning

confidence: 99%

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Measures of adiposity correlate with renal filtration in young nulliparous women: An observational cohort study

Williams

McBride

Badger

et al. 2019

Obesity Science & Practice

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Summary Objective Renal hyperfiltration, which has been documented in severe obesity and obesity‐associated hypertension, can occur with hypertensive disorders of pregnancy. Identification of prepregnancy risk factors for unrecognized renal hyperfiltration could inform screening and intervention strategies to protect against pregnancy complications. In young, healthy, nulliparous women, associations between associations between measures of adiposity, insulin resistance, and renal vascular resistance were thus evaluated. Methods This is a secondary analysis of a prospective observational trial characterizing associations of prepregnancy and late‐pregnancy maternal physiology. Seventy‐nine nulligravid women aged 18‐42 years without major medical conditions were assessed for percent android body fat using dual‐energy X‐ray absorption. Renal cortical vessel blood flow resistance index (CVRI) was determined using Doppler ultrasonography. Creatinine clearance was calculated from 24‐hour urine collection. Results Renal CVRI inversely correlates with body mass index (r = ‐0.23, p = 0.047), percent android fat (r = ‐0.30, p = 0.008), and supine pulse (r = ‐0.44, p < 0.001). Creatinine clearance is positively associated with BMI and HOMA‐IR. In regression modeling, supine pulse (r2 = 0.22, p < 0.001) and cardiac index (r2 = 0.05, p = 0.045) predict renal CVRI, whereas HOMA‐IR (r2 = 0.11, p = 0.008) and cardiac output (r2 = 0.06, p = 0.039) predict creatinine clearance. Measures of adiposity are not independently predictive of either measure. Conclusions In healthy young women, measures of adiposity and insulin resistance correlate positively with renal filtration. Preclinical manifestations of renal hyperfiltration may have implications for pregnancy outcomes.

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Section: Discussionsupporting

confidence: 54%

“…Ultrasound indices of renal vascular resistance were assessed according to previously described methods . In brief, with subjects in supine position, a single expert operator (I.B.)…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Measures of adiposity correlate with renal filtration in young nulliparous women: An observational cohort study

Williams

McBride

Badger

et al. 2019

Obesity Science & Practice

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“…In addition, the employment of contrast agent associated with power Doppler imaging enables the mapping of regional flow differences in the kidney . Duplex Doppler is employed to evaluate the intrarenal blood flow that is expressed as the resistive index (RI) , which is calculated from the peak‐systolic and end‐diastolic velocities . In cases of abnormal RI values, the therapeutic response may be assessed by performing serial exams .…”

Section: Introductionmentioning

confidence: 99%

Renal evaluation with B‐mode and Doppler ultrasound in captive tufted capuchins (Sapajus apella)

Silva

Machado

Teixeira

et al. 2015

J of Medical Primatology

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“…Future studies are planned that will prospectively collect more detailed information of invasive haemodynamics and optimize CT or magnetic resonance image acquisition protocols. This will permit: (1) the standardization of image resolution for increased feasibility of volume segmentation, (2) the enhancement of in silico predictions by complementary non-invasive measures of renal artery blood flow using Doppler sonography ( Li et al, 2008 ; Kaya, 2012 ), and (3) the more direct comparison of in silico with in vivo predictions by more precisely specifying the location of pressure measurements.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive Stenotic Renal Artery Haemodynamics by in silico Medicine

et al. 2018

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Background: Measuring the extent to which renal artery stenosis (RAS) alters renal haemodynamics may permit precision medicine by physiologically guided revascularization. This currently requires invasive intra-arterial pressure measurement with associated risks and is rarely performed. The present proof-of-concept study investigates an in silico approach that uses computational fluid dynamic (CFD) modeling to non-invasively estimate renal artery haemodynamics from routine anatomical computed tomography (CT) imaging of RAS.Methods: We evaluated 10 patients with RAS by CT angiography. Intra-arterial renal haemodynamics were invasively measured by a transducing catheter under resting and hyperaemic conditions, calculating the translesional ratio of distal to proximal pressure (Pd/Pa). The diagnostic and quantitative accuracy of the CFD-derived virtual Pd/Pa ratio (vPd/Pa) was evaluated against the invasively measured Pd/Pa ratio (mPd/Pa).Results: Hyperaemic haemodynamics was infeasible and CT angiography in 4 patients had insufficient image resolution. Resting flow data is thus reported for 7 stenosed arteries from 6 patients (one patient had bilateral RAS). The comparison showed a mean difference of 0.015 (95% confidence intervals of ± 0.08), mean absolute error of 0.064, and a Pearson correlation coefficient of 0.6, with diagnostic accuracy for a physiologically significant Pd/Pa of ≤ 0.9 at 86%.Conclusion: We describe the first in silico estimation of renal artery haemodynamics from CT angiography in patients with RAS, showing it is feasible and diagnostically accurate. This provides a methodological framework for larger prospective studies to ultimately develop non-invasive precision medicine approaches for studies and interventions of RAS and resistant hypertension.

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The Evaluation of Renal Hemodynamics with Doppler Ultrasonography

Cited by 9 publications

References 126 publications

Measures of adiposity correlate with renal filtration in young nulliparous women: An observational cohort study

Measures of adiposity correlate with renal filtration in young nulliparous women: An observational cohort study

Renal evaluation with B‐mode and Doppler ultrasound in captive tufted capuchins (Sapajus apella)

Non-invasive Stenotic Renal Artery Haemodynamics by in silico Medicine

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