Abstract: TH-PO464

Renal Resistive Index in Cortical but Not in Segmental Arteries Reflects Renal Perfusion in Hypertensive CKD Patients

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular


  • Lubas, Arkadiusz, Military Institute of Medicine, Warsaw, Poland
  • Niemczyk, Stanislaw, Military Institute of Medicine, Warsaw, Poland

Renal Resistive Index in segmental arteries (RI-S) is a well known marker of cardiovascular and renal organ damage. In many studies it is used as a marker of Renal Perfusion (RP). However this relation was not proved. Renal Resistive Index in cortical arteries (RI-C) is erroneously used as RI-S, because the difference between these indexes is unclear.
The aim of the study was to investigate relations between segmental and cortical renal Resistive Indexes and Renal Perfusion.


Fifty patients (3F; 47M; age 56.6 ±13.3) with stable CKD (CKD-EPI 57.4 ±28.4 ml/min/1.73m2) and a history of hypertension were enrolled in the study. Ultrasonic color and duplex Doppler examinations of intrarenal arteries in the right kidneys were performed. RI-S was calculated as a mean of 3 measurements. RI-C and RP (arterio-venous mean perfusion [mL/s]) were calculated with the use of Dynamic Tissue Perfusion Method (PixelFlux software). Echocardiographic Cardiac Index (CI), IMT, 24-h Pulse Pressure (PP) and renal function expressed as Creatinine and Cystatin based CKD-EPI formula were estimated.


Renal Resistive Indexes were significantly correlated (r=0.63; R2=0.40; p<0.001), but RI-S was lower than RI-C (0.684 ±0.075 vs 0.728 ±0.131; p=0.004). In the univariable analysis RI-S and RI-C both were significantly correlated with age, IMT, PP, CI, CKD-EPI, and RP. The multivariable regression analysis adjusted to age and BMI showed that CKD-EPI (p<0.001), CI (p=0.005) and PP (p=0.014) independently influenced RI-S (R2=0.55, p<0.001). The same analysis for RI-C revealed an independent relation (R2=0.41, p<0.001) with PR (p<0.001) and CI (p=0.024). When RI-S was added to the regression equation PR (p<0.001) and RI-S (p<0.001) independently modified RI-C (R2=0.51, p<0.001).


Renal Resistive Index in segmental arteries is independently modified by cardiovascular and renal organ damage parameters with the exclusion of the Renal Perfusion. Although RI-S and RI-C correlate with each other, their values differ significantly. Renal cortical Resistive Index reflects both Renal Perfusion and segmental Resistive Index. Segmental and cortical renal Resistive Indexes cannot be used interchangeably.


  • Government Support - Non-U.S.