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Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis: a monocentric observational study.
Bruno, Rosa Maria; Daghini, Elena; Versari, Daniele; Sgrò, Melania; Sanna, Michela; Venturini, Luigi; Romanini, Caterina; Di Paco, Irene; Sudano, Isabella; Cioni, Roberto; Lerman, Lilach O; Ghiadoni, Lorenzo; Taddei, Stefano; Pinto, Stefania.
Afiliación
  • Bruno RM; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. rosam.bruno@gmail.com.
Cardiovasc Ultrasound ; 12: 9, 2014 Feb 20.
Article en En | MEDLINE | ID: mdl-24555729
BACKGROUND: The present study evaluated the predictive value of renal resistive index (RI) for renal function and blood pressure (BP) outcome in hypertensive patients with unilateral atherosclerotic renal artery stenosis submitted to successful revascularization. METHODS: In 158 hypertensive patients with atherosclerotic renal artery stenosis RI was acquired. Twelve months after revascularization, they were classified on the basis of renal function and BP outcome as benefit (BP < 140/90 mmHg or diastolic BP reduction > 15 mmHg with the same of reduced drugs; decrease in glomerular filtration rate > 20%), or failure. RESULTS: Regarding renal function outcome, RI in the stenotic and in the contralateral kidney were significantly higher in patients with failure (n = 20) than in those with benefit (0.72 ± 0.11 vs 0.61 ± 0.11 and 0.76 ± 0.08 vs 0.66 ± 0.09, p < 0.05). Among different cutpoints generated, RI in the contralateral kidney >0.73 provided the largest area under the curve (0.77), and the highest sensitivity (80%) and specificity (72%). In the multivariate logistic regression analysis, RI in the contralateral kidney >0.73 was an independent predictor of a failure in renal function outcome.Regarding BP outcome, patients with no benefit from revascularization (n = 60) had similar RI in the stenotic and contralateral kidney (p = ns), but presented higher pulse pressure, albuminuria and hypertension duration in comparison to patients with improved BP control. CONCLUSIONS: RI in the contralateral kidney is an independent predictor of renal function outcome after successful revascularization in hypertensive patients with unilateral atherosclerotic renal artery stenosis, whereas it is not able to predict blood pressure outcome.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obstrucción de la Arteria Renal / Interpretación de Imagen Asistida por Computador / Diagnóstico por Imagen de Elasticidad / Hipertensión Renovascular Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Ultrasound Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2014 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obstrucción de la Arteria Renal / Interpretación de Imagen Asistida por Computador / Diagnóstico por Imagen de Elasticidad / Hipertensión Renovascular Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Ultrasound Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / DIAGNOSTICO POR IMAGEM Año: 2014 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Reino Unido