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

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.

scholarly journals Non-invasive evaluation of obstruction after ureteroscopic stone removal: Role of renal resistive index assessment

2020 ◽  
Vol 92 (3) ◽  
Author(s):  
Bilal Eryildirim ◽  
Ahmet Şahan ◽  
Özlem Türkoğlu ◽  
Murat Tuncer ◽  
Övünç Kavukoğlu ◽  
...  
Keyword(s):  
Ureteral Obstruction ◽  
Doppler Ultrasonography ◽  
Resistive Index ◽  
Renal Resistive Index ◽  
Stent Insertion ◽  
Before And After ◽  
Stone Treatment ◽  
Renal Doppler Ultrasonography ◽  
Stone Characteristics ◽  
Renal Doppler

Objectives: The aim of this study is to evaluate prediction of postoperative ureteral obstruction needing ureteral stent insertion by evaluating the resistive index (RI) values and the grade of hydronephrosis. Material and Methods: A total of 66 adult patients undergoing stentless endoscopic ureteral stone treatment (URS) between January 2018 and January 2019 were included in this prospective study. Preoperative patient and stone characteristics were noted. All patients were evaluated with renal Doppler ultrasonography study to assess degree of hydronephrosis and RI values. A renal Doppler ultrasonography was repeated at postoperative 1st, 3rd and 7th days. Changes in both RI and hydronephrosis levels before and after the procedures were noted. On the postoperative 7th day, patients were divided into two groups including obstructive and non-obstructive cases according to RI values assessed where a RI value of 0.7 was accepted as the cut-off for obstruction. The preoperative and perioperative characteristics of both groups were evaluated in a comparative manner. Results: The mean patient age was 43.6 ± 1.72 years. Significant improvements were noted in RI and grade of hydronephrosis after the operation. The grade of hydronephrosis and RI values were found to improve more significantly on postoperative 3rd day when compared to the postoperative 7th day (p < 0.01 and p < 0.01). A significant correlation was detected between the grade of hydronephrosis (>grade 2) and obstructive RI values (> 0.7) in each postoperative visits (p: 0.001). RI values (> 0.7) at postoperative seventh days were correlated with larger mean stone size, increased ureteral wall thickness, increased diameter of the ureter proximal to the stone, and longer duration of the operation. Preoperative high-grade hydronephrosis indicated obstructive RI values at postoperative seventh day (p = 0.001) Conclusion: Changes in RI values on Doppler sonography and the grade of hydronephrosis may be a guiding parameter in assessing postoperative ureteral obstruction.

scholarly journals Ratio of diastolic to systolic blood pressure represents renal resistive index

2019 ◽  
Vol 34 (7) ◽  
pp. 512-519 ◽  
Author(s):  
Tetsuya Akaishi ◽  
Michiaki Abe ◽  
Takashi Miki ◽  
Mika Miki ◽  
Yasuharu Funamizu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Vascular Resistance ◽  
Pulse Pressure ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Resistive Index ◽  
Renal Resistive Index

Abstract Increased intrarenal vascular resistance is suggested to accompany chronic kidney diseases (CKD), which is known to be closely associated with hypertension. However, there are few studies that have examined the relationship between blood pressure and intrarenal vascular resistance. Renal color Doppler ultrasonography is one method that can non-invasively evaluate intrarenal vascular resistance. In this study, we comprehensively studied the correlations between ultrasonic parameters and blood pressure indices to elucidate their relationships. In total, 162 patients with suspected CKD were enrolled for this study. Demographics, blood pressure, blood test, urine test, and renal color Doppler ultrasonography data were obtained. The ratio of diastolic to systolic blood pressure (D/S ratio) and pulse pressure were calculated. Our results indicated strong negative correlations between the renal resistive index (RI) values in all four of the studied kidney regions and the D/S ratio. The RI values also showed significant correlations with diastolic pressure and pulse pressure, but they were weaker. Partial correlation coefficients between pulse pressure, mean arterial pressure, D/S ratio, and RI showed that D/S ratio significantly correlated with RI, but pulse pressure or mean arterial pressure did not. Systolic blood pressure did not correlate with any of the studied ultrasonic values. The negative correlation between RI values and the D/S ratio was still observed in subjects without renal dysfunction or any medications. In conclusion, D/S ratio, rather than pulse pressure or mean arterial pressure, would be the most appropriate index to estimate/calculate/judge intrarenal vascular resistance.

scholarly journals Systolic blood pressure of dogs at hospital and domestic environment

2012 ◽  
Vol 42 (7) ◽  
pp. 1242-1248
Author(s):  
Frederico Aécio Carvalho Soares ◽  
Elisa Barp Neuwald ◽  
Verônica Santos Mombach ◽  
Ana Elize Ribeiro D'Avila ◽  
Francisco de Oliveira Conrado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Doppler Ultrasonography ◽  
Serum Cortisol ◽  
Serum Concentrations ◽  
Pathological Conditions ◽  
Healthy Dogs ◽  
The Mean ◽  
Veterinary Hospital ◽  
At Home

The measurement of blood pressure (BP) is an important assessment of the cardiovascular system, being influenced by physical and pathological conditions. Certain situations of stress and anxiety during BP measurement can lead to elevated values in small animals, known in medicine as "white coat effect". The aim of this research was to compare systolic blood pressure (SBP) measurement using Doppler ultrasonography in 45 adult healthy dogs in two environments, at a veterinary hospital and at home. Comparison of heart rate, serum concentrations of cortisol and glucose intended to help the evaluation of the stress level of the animals. The mean of SBP at the veterinary hospital was 154.7mmHg and it was significantly (P<0.01) higher than at home (136.3mmHg). It was also observed that HR (mean=122.7bpm), and serum cortisol (median=4.5µg dL-1) and glucose (mean=95.9mg dL-1) concentrations were significantly higher (P<0.01) at the hospital, when compared with values obtained at home (109.6bpm; 1.5µg dL-1 and 85.5mg dL-1, respectively). In conclusion, the environment can influence SBP in dogs, due to factors related to stress.

scholarly journals KORELASI UKURAN KETEBALAN KORTEKS DAN RESISTIVE INDEX GINJAL BERDASARKAN PEMERIKSAAN ULTRASONOGRAFI PADA PASIEN HIDRONEFROSIS

2019 ◽  
Vol 12 (2) ◽  
pp. 183
Author(s):  
Ferawati Dakio ◽  
Nurlaily Idris ◽  
Mirna Muis ◽  
Andi Alfian ◽  
Hasyim Kasim ◽  
...  
Keyword(s):  
Doppler Ultrasonography ◽  
Resistive Index ◽  
Radiology Department ◽  
Renal Resistive Index ◽  
Cross Sectional ◽  
Correlation Tests ◽  
The Mean ◽  
Cross Sectional Design ◽  
The Right ◽  
Superior Pole

Hidronefrosis dapat terjadi pada satu atau kedua ginjal yang menyebabkan aliran urine menjadi lemah dan mengganggu fungsi dari ginjal itu sendiri.Penelitian ini bertujuan mengetahui korelasi ketebalan korteks ginjal dan resistive index ginjal berdasarkan pemeriksaan ultrasonografi pada pasien hidronefrosis. Penelitian ini dilakukan di bagian Radiologi Rumah Sakit Umum Pusat Dr. Wahidin Sudirohusodo Makassar dari Mei sampai dengan Agustus 2018. Desain penelitian yang digunakan adalah observasional dengan rancangan potong lintang.Sampel penelitian sebanyak empat puluh orang yang memiliki klinis hidronefrosis. Pemeriksaan ultrasonografi grayscale terhadap pasien dilakukan untuk mengukur ketebalan korteks ginjal yang dilakukan di bagian tengah ginjal pada potongan longitudinal dan diukur dari puncak piramid tegak lurus ke arah kapsul, kemudian dilanjutkan pemeriksaan ultrasonografi doppler di arteri interlobar atau arcuata pada pole superior, median, dan inferior ginjal untuk menilai  renal resistiveindex. Data dianalisis dengan analisis statistik melalui uji korelasi Spearman dan Pearson.Hasil penelitian menunjukkan bahwa rerata sampel penelitian mengalami hidronefrosis derajat ringan. Mean tebal korteks ginjal kanan pada penelitian ini 0,9 cm (0,26-1,79cm) dan ginjal kiri 0,84 cm (0,22-1,57cm). Terdapat korelasi yang bermakna antara derajat hidronefrosis dengan ketebalan korteks ginjal kanan dan kiri dengan arah korelasi negatif (p=0,0001). Kecenderungan peningkatan derajat hidronefrosis, meningkatkan nilai resistive index meskipun secara statistik tidak bermakna. Tidak terdapat korelasi antara ketebalan korteks dan resistive index  ginjal berdasarkan pemeriksaan ultrasonografi.   Hydronephrosis can occur in one or both kidneys which causes the flow of urine to become weak and interfere with the function of the kidney. This research aimed to investigate the correlation between the cortex thickness and the resistive index of kidney based on the ultrasonography examination in hydronephrosis patients.  The research was conducted in Radiology Department of Dr. Wahidin Sudirohusodo General Hospital, Makassar from May through August 2018. The research design used was observational using the cross sectional design. The total samples comprised 40 samples with clinical hydronephrosis. The examination of ultrasonography grayscale was carried out in order to measure the cortex thickness of the kidneys in the central parts of kidneys and the longitudinal cut was measured from the pyramid top straight down the capsule, then it was continued with the Doppler ultrasonography examination in the interlobare artery or arcute at superior pole, median and inferior kidney in order to evaluate the renal resistive index. The data were analyzed using the statistical analysis through the correlation tests of Spearman and Pearson. The research results indicated that the mean research samples had experienced the light hydronephrosis. The mean cortex thickness of the right kidney was 0.9 cm (0.26 - 1.79 cm), and that of the left kidnet was 0.84 cm (0.22 - 1.57 cm). There was a significant correlation between the degree of hydronephrosis and the cortex thickness of the right and the left kidneys, with the direction of the negative correlation (p=0.0001). There was a tendency of the increase of hydronephrosis degree to increase the value of resistive index, though statistically it was insignificant. There was no correlation between the cortex thickness and the resistive index of kidney based on the ultrasonogrphy examination.  

scholarly journals Comparison of renal arterial resistive index in type 2 diabetic nephropathy stage 0-4

2019 ◽  
Vol 29 (4) ◽  
Author(s):  
Sharareh Sanei Sistani ◽  
Ali Alidadi ◽  
Alireza Ansari Moghadam ◽  
Fatemeh Mohamadnezhad ◽  
Bahareh Heshmat Ghahderijani
Keyword(s):  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Resistive Index ◽  
Chronic Kidney Failure ◽  
World Health ◽  
Renal Resistive Index ◽  
Cross Sectional ◽  
Cardiovascular Morbidity And Mortality

Chronic kidney disease (CKD) is one of world health problems and its prevalence and incidence is increasing. Chronic Kidney Failure involves a range of pathophysiologic processes that are associated with impaired renal function, leading to cardiovascular morbidity and mortality. Renal artery resistive index (RI) is indicator of atherosclerotic change in small vessels. The current study was aimed to assess RI in diabetic nephropathy patients at stage 0-4 and to compare RRI with HbA1c, systolic blood pressure, diastolic blood pressure, albuminuria and glomerular filtration rate (GFR). In this cross sectional study,100 diabetic nephropathy patients who attend to nephrology clinic of Ali-ibn Abi Talib Hospital were entered to the study. Ultrasound Doppler renal resistive index was measured and other information was recorded from their last lab data that was recorded in their medical records. Variable included: systolic blood pressure, diastolic blood pressure, albuminuria, GFR, HbA1c. All data was analyzed by Pearson's Correlation Coefficient. The findings indicated a significant correlation of RI with systolic BP (p=0.04 R=0.75), microalbuminuria (P=0.001 R=0.67), and GFR (P=0.001 R=0.76), while diastolic BP (P=0/45 R=0/32), HbA1c (P=0/56 R=0/43) were not found to be associated with RI. The findings indicated that increased systolic blood pressure, albumin excretion (microalbuminuria) and severity of disease were capable of increasing RI values in diabetic nephropathy patients. In addition, decreased GFR.

scholarly journals Relation between Renal Resistive Index and Serum Albumin in Nephrotic Syndrome

2021 ◽  
Vol 10 (30) ◽  
pp. 2228-2232
Author(s):  
Pranoy Dey ◽  
Niku Hage
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Albumin ◽  
Serum Albumin Level ◽  
Left Kidney ◽  
Peak Systolic Velocity ◽  
Resistive Index ◽  
Albumin Level ◽  
Renal Resistive Index ◽  
The Mean ◽  
Renal Doppler

BACKGROUND Renal resistive index (RRI) is a non-invasive marker of renal function, which can be measured by renal USG Doppler. High RI indicates poor prognosis, which has been associated with conditions such as proteinuria, hypertension, chronic kidney disease and renal failure. As nephrotic syndrome is characterised by significant proteinuria and hypoalbuminemia, which may progress to renal failure, it is important to see the correlation of RRI with serum albumin level. The purpose of this study was to assess the relation between renal resistive index and serum albumin in nephrotic syndrome. METHODS USG renal Doppler was done for all the children with nephrotic syndrome and RRI was calculated as [(peak - systolic velocity − end - diastolic velocity) / peak - systolic velocity]. Blood investigations were also done, from which serum albumin values were obtained. RRI was compared with mean serum albumin level. Statistical analysis of data was performed using the computer programme, Statistical Package for Social Sciences (SPSS for windows, version 21.01, Chicago, SPSS Inc.) and Microsoft excel 2010. Results on continuous measurement were presented as mean ± standard deviation and compared using Analysis of Variance (ANOVA). RESULTS The mean serum albumin in the children with nephrotic syndrome in our study was 1.82 ± 0.32 gm / dl. The mean RI value was 0.66 ± 0.14 SD, 0.64 ± 0.15 SD and 0.66 ± 0.12 SD as well as 0.63 ± 0.12 SD, 0.67 ± 0.16 SD and 0.71 ± 0.13 SD on the right and left kidney respectively for each of upper, middle, and lower pole. P value of left kidney and right kidney was 0.0057 and 0.6409 respectively. CONCLUSIONS Lower the mean serum albumin level, higher the range of RRI. KEY WORDS Serum Albumin, Renal Resistive Index, Nephrotic Syndrome, USG Renal Doppler

scholarly journals Low systolic blood pressure values, renal resistive index measurement and glomerular filtration rate in a non-dialysis dependent chronic kidney disease population

2019 ◽  
Vol 90 (4) ◽  
pp. 288-292
Author(s):  
Simone Brardi ◽  
Gabriele Cevenini
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Systolic Blood Pressure ◽  
Filtration Rate ◽  
Left Kidney ◽  
Resistive Index ◽  
Renal Resistive Index

Objective: A longitudinal prospective case control study was organized to explore the relationships between glomerular filtration rate (GFR), renal resistive index (RRI) and blood pressure values in a non-dialysis dependent adult population affected by chronic kidney disease and exposed to low systolic blood pressure (SBP) values.Material and methods: The study sample (54 patients: 31 males and 23 females with an average age of 61.7 ± 19.2 years) was randomly selected from a population of adult non-dialysis dependent patients that scored a SBP < 100 mmHg at the medical examination. The patients were equally divided in two groups defined by the presence and absence of chronic kidney disease, (i.e. a GFR less or greater than 60 ml/min/1.73 m2, respectively). Patients were submitted to a full therapeutic and dietetic intervention to correct the hypotension until reaching a steady SBP > 100 mmHg. Results: In the group with chronic renal disease, the comparison between the data recorded with SBP < 100 mmHg (t0) and those detected with SBP ≥ 100 mmHg (t1) showed a statistically significant decrease of serum creatinine as well as an increase of GFR (mean serum creatinine t0 – serum creatinine t1: 0.194 ± 0.35, p < 0.01; mean GFR t0 – GFR t1: -4.615 ± 8.8, p < 0.013). There was also a statistically significant reduction of the RRI (mean right kidney RRI t0 – mean right kidney RRI t1: + 0.082 ± 0.03, p < 0; mean left kidney RRI t0 – mean left kidney RRI t1: 0.076 ± 0.03, p < 0). Conclusion: We concluded that, in CKD, when aorta is stiffed, a decrease of SBP can limit the renal perfusion that, in this condition, is mostly dependent by stroke volume, causing an increase of RRI and a decrease of GFR that we suppose as reversible with the restoration of SBP.

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