The Science and Innovation Behind Google Maps and Renal-Resistive Index

Introduction: The relationship of renal haemodynamics with cardiac and aortic hameodynamics is still unclear. Hypothesis: We evaluated the relationship of increased renal resistive index (RRI) with Augmentation index (AIx) and cardiac haemodynamics by means of mitral annular early diastolic velocity (E/Ea) in untreated patients with essential hypertension. Methods: 76 newly diagnosed untreated non diabetic patients with stage I-II essential hypertension [35 males, aged 50 years, office blood pressure (BP) = 143/ 91 mm Hg], underwent ABPM, complete echocardiographic study for determination of E/Ea and blood sampling for assessment of metabolic profile. Moreover, data on renal resistive index (RRI), obtained by Doppler ultrasound sampling of the intrarenal arteries, as well as augmentation index (AIx), were retrospectively analyzed. Results: Based on the mean value of RRI (0.60), hypertensives were classified into those with high and low RRI. Hypertensives with high RRI values compared to those with low values were older (55.6±9.8 vs 44.4±11.6 years, p < 0.001), had lower 24-hour diastolic BP (77.5±7.7 vs 84.3±6.7 mmHg, p < 0.001), lower 24-hour HR (71.2±10.3 vs 76.2±9.2 bpm, p < 0.05), higher levels of AIx (27.2±8.2 vs 17.8±14.8 %, p < 0.01), and higher values of E/Ea (lateral) (7.7±1.8 vs 6.2±2.3, p < 0.05). In the total population, RRI was negatively related to 24-hour diastolic BP (r = -0.523, p < 0.001) and 24-hour HR (r = -0.281, p < 0.05), while it was positively associated with CRP (r = 0.335, p < 0.05), TChol (r = 0.296, p < 0.01), age (r = 0.443, r < 0.001), AIx (r = 0.413, p = 0.001) and E/Ea(lateral) (r = 0.465, p < 0.05). Multiple regression analysis revealed that 24-hour diastolic BP and E/Ea (lateral) were independent associated with RRI (R2 = 0.434, p < 0.05). Conclusions: Increased vascular resistance of intrarenal arteries is associated with impaired aortic and cardiac haemodynamics, as reflected by increased AIx and E/Ea (lateral) values. RRI may be considered a useful surrogate of haemodynamics in essential hypertension.

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Abstract P358: Association of Kidney Function and Cerebral Arterial Stiffness

Stroke ◽

10.1161/str.52.suppl_1.p358 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Eung-Joon Lee ◽

Hae Bong Jeong ◽

Ki-woong Nam ◽

Kipyoung Jeon ◽

Jeonghoon Bae ◽

...

Keyword(s):

Renal Function ◽

Arterial Stiffness ◽

Renal Dysfunction ◽

Doppler Ultrasound ◽

Resistive Index ◽

Retrospective Chart Review ◽

Transcranial Doppler Ultrasound ◽

Lacunar Infarction ◽

Renal Resistive Index ◽

Proportional Relationship

Background and Purpose: Chronic kidney disease (CKD) is known to have affected the systemic vasculature and its remodeling, which eventually led to the systemic arterial stiffness. However, the relationship between cerebral circulation and impaired renal function is poorly understood. To evaluate the effect of renal dysfunction to increase systemic and intracranial arterial stiffness, we assessed the relation between renal resistive index (RRI) and pulsatility index (PI) of the middle cerebral artery (MCA). Methods: We included patients with acute lacunar infarction. Demographic and clinical data were collected by retrospective chart review. Bilateral transcranial Doppler ultrasound (TCD) examination of the MCAs was performed using the ST3 Ultrasound system (Spencer Technologies) and PI were calculated. RRI was obtained through kidney Doppler sonography. Subjects with occlusion or significant stenosis of MCA, atrial fibrillation, bilaterally absent transtemporal sonographic windows were excluded. Results: Of the 283 included subjects (mean age 67.8 ± 10.2), 74 patients had renal dysfunction (glomerular filtration rate < 60ml/min/1.73m2 at admission) and 49 patients underwent kidney Doppler ultrasound within 1 year since their acute stroke. Renal dysfunction was significantly associated with higher arterial stiffness (median PI 1.12, IQR 0.85 to 1.57 vs. controls PI 0.84, IQR 0.54 to 1.22 [p<0.0001]). There was a proportional relationship between the degree of renal dysfunction and the distal vascular resistance. In multivariate adjusted regression analysis, renal function was related to high PI (p<0.001). Furthermore, there is strong correlation between RRI and PI ( r =0.65, p <0.001). Conclusions: In patients with lacunar infarction, renal impairment is an independent determinant of increased arterial stiffness in cerebral circulations. In addition, PI is significantly associated with RRI.

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EVALUATION OF REFLUX KIDNEY USING RENAL RESISTIVE INDEX

The Journal of Urology ◽

10.1016/s0022-5347(05)66282-9 ◽

2001 ◽

Vol 165 (6 Part 1) ◽

pp. 2010-2012 ◽

Cited By ~ 8

Author(s):

AKIHIRO KAWAUCHI ◽

YUTAKA YAMAO ◽

OSAMU UKIMURA ◽

KAZUMI KAMOI ◽

JINTETSU SOH ◽

...

Keyword(s):

Resistive Index ◽

Renal Resistive Index

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Longitudinal prospective observational type study about determinants of renal resistive index variations in chronic renal failure patients treated with conventional medical and dietetic therapy

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2017.4.305 ◽

2017 ◽

Vol 89 (4) ◽

pp. 305

Author(s):

Simone Brardi ◽

Gabriele Cevenini ◽

Vanni Giovannelli ◽

Giuseppe Romano

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Doppler Ultrasonography ◽

Urinary Albumin Excretion ◽

Resistive Index ◽

Renal Resistive Index ◽

The Mean ◽

Renal Doppler Ultrasonography ◽

Renal Doppler

Objective: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. Material and methods: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo. The study population (84 patients: 47 males and 37 females) was randomly selected among the chronic kidney patients (with various degrees of renal impairment) affected by hypertension and or diabetes mellitus. After a comprehensive medical examination these patients were submitted to determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and finally renal Doppler ultrasonography. Then the patients were submitted to a full therapeutic and dietetic intervention to ameliorate the renal impairment by a wide range of actions and after on average a one-year interval were submitted again to a new medical examination and a second determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and a new renal Doppler ultrasonography too. Results: The comparison between basal and final data revealed a slight reduction in the mean of bilateral renal resistance indices (Delta RRI: -0.0182 ± 0.08), associated to a slight increase in the mean glomerular filtration rate (Delta GFR: 0.8738 ± 10.95 ml/min/1.73 m2), a reduction in mean body weight (Delta weight: -1.9548 ± 5.26 Kg) and mean BMI (Delta BMI: -0.7643 ± 2.10 Kg/m2) as well as a reduction in the mean systolic blood pressure (Delta systolic blood pressure: -8.8333 ± 25.19 mmHg). Statistical analysis showed statistically significant correlations (p < 0.05) between Delta RRI and Delta weight (p < 0.03), Delta BMI (p < 0.02) and Delta systolic blood pressure (p < 0.05). Conclusion: Despite the many limitations the our study clearly identifies the targets (yet widely known) to act on to prevent kidney alterations related to RRI and provides further evidence, if any, of the utility of RRI as a key parameter in monitoring patients with chronic renal failure and as a valuable tool to drive the clinical efforts to contrast the kidney disease.

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Hypertension is Common in Patients with Newly Diagnosed Acromegaly and is Independently Associated with Renal Resistive Index

High Blood Pressure & Cardiovascular Prevention ◽

10.1007/s40292-018-0293-9 ◽

2018 ◽

Vol 26 (1) ◽

pp. 69-75 ◽

Cited By ~ 1

Author(s):

Hilmi Erdem Sumbul ◽

Ayse Selcan Koc

Keyword(s):

Resistive Index ◽

Renal Resistive Index ◽

Newly Diagnosed

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AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL

Indonesian Journal of Urology ◽

10.32421/juri.v21i1.7 ◽

2014 ◽

Vol 21 (1) ◽

Author(s):

Anton Hermawan ◽

Sabilal Alif ◽

Wahjoe Djatisoesanto ◽

Tri Wulanhandarini ◽

Budiono Budiono

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Color Doppler ◽

Resistive Index ◽

Renal Resistive Index ◽

Kidney Calculi ◽

Pelvic Kidney ◽

Extracorporeal Shock Wave ◽

Age Related

Objective: To determine relation between age and resistive index (RI) changes occurring after extracorporeal shock wave lithotripsy (ESWL). Material & Method: We performed a prospective study in Soetomo Hospital Surabaya. Using duplex ultrasonography, RI was determined in 20 patients with calyceal kidney calculi and pelvic kidney calculi. RI of the interlobar renal arteries were measured in the region near the calculi (distance, less than 2 cm), one hour before ESWL and RI was measured again at 1 hour, 3 days and 7 days after ESWL. Changes in RI values and relation with age (≤ 60 years old and > 60 years old) were evaluated. Results: The renal RI increased significantly 1 hour and 3 days after ESWL, but returned to before ESWL values 7 days after ESWL in the both groups. Although there was positive correlation between age and RI before ESWL, but there was no correlation between age and RI changes after ESWL. Conclusion: Renal RI is higher with age > 60 years, after ESWL renal RI showed transient increase which returned to baseline after 7 days.Key words: Color Doppler Ultrasonography, extracorporeal shock wave lithotripsy, renal resistive index, calyceal kidney calculi, pelvic kidney calculi.

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