Kidney Week

Abstract: FR-PO163

Doppler Indexes of the Renal Cortex Are Independently Related to Renal Perfusion in Hypertensive CKD Patients

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

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

Arkadiusz Lubas,

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

Stanislaw Niemczyk,

Background

In many studies, Resistive Index measured in segmental or interlobular intrarenal arteries has been used interchangeably as an equivalent of renal perfusion. Due to the diverging region of measurement, achieved indexes are significantly different. However, they were not compared to the renal perfusion estimated in the independent method. The study aimed to investigate relations between different renal Doppler indexes (segmental renal Resistive Index (sRI), cortical renal Resistive Index (cRI), cortical renal Pulsatility Index (cPI)) and Renal Perfusion (RP) measured in contrast-enhanced computed tomography.

Methods

In fifteen patients (6F, 9M; age 61.5 ±19.3) with unilateral renal artery stenosis, ultrasound examination (GE Logic P6) with the estimation of sRI (a mean of 3 measurements using a Pulsed Wave Doppler); cRRI and cRPI (3-5 seconds movie of Color Doppler with PixelFlux software [Chameleon Software, Germany]) was performed. Then contrast-enhanced multidetector computed tomography (GE Discovery 750 HD) of renal and intrarenal arteries was completed, and a Renal Blood Flow in a whole cortex (cRBF, [mL/s/100g]) was measured. The data from 15 kidneys without a stenotic artery were considered for statistics. Based on creatinine, estimated glomerular filtration rate (eGFR) was calculated using MDRD formula.

Results

Values of intranenal indexes were estimated: sRI = 0.710 ±0.107; cRI = 0.751 ±0.185; cPI = 1.515 ±0.614, whereas mean RP = 206.8 ±64.9 ml/s/100g and eGFR = 54.8 ±29.6 ml/min/1.73m². All intrarenal Doppler indexes correlated significantly with age, eGFR, and with each other. In addition, cRI and cPI correlated with RP (r = -0.547, p < 0.05 and r = -0.655, p < 0.05, respectively). The multivariable regression analysis adjusted to age and eGFR showed independent connection between cRI and RP (b = -0.55; R² = 0.30, p < 0.035). In the same regression model, cPI independently related to RP (b = -0.65; R² = 0.43, p < 0.008). However, relation to RP was not significant for sRI (p < 0.112).

Conclusion

Doppler indexes measured in renal cortex area are independently related to the renal perfusion. Renal Resistive Index in segmental arteries should not be considered as a marker of renal cortical blood flow

Funding

• Government Support - Non-U.S.