Background: Mild renal dysfunction (MRD) is an often overlooked but relatively common condition in patients with primary hypertension (PH), and is associated with high cardiovascular morbidity and mortality. Whether MRD is also associated with abnormalities in renal vascular resistance is currently unknown. Methods: Two hundred ninety-one untreated patients with PH were studied. The MRD was defined as a creatinine clearance>=60 mL/min but <90 mL/min (Cockcroft-Gault formula) or the presence of microalbuminuria. Albuminuria was measured as the albumin-to-creatinine ratio in first morning urine samples. Renal resistive index (RI) was evaluated by ultrasound Doppler of the interlobar arteries. Results: The prevalence of MRD in our cohort was 63%. Patients with MRD were older, had higher mean blood pressure (BP), pulse pressure, and total cholesterol, longer history of hypertension, and were more likely to be men. Renal RI was positively related to female gender, age, systolic BP, pulse pressure, total cholesterol, albuminuria, and to carotid wall thickness and cross-sectional area, whereas it was inversely related to diastolic BP and creatinine clearance. Patients with the highest renal resistance (upper quartile,>=0.63) showed a greater prevalence of renal dysfunction (P = .0005). After adjusting for age, pulse pressure, and LDLcholesterol, we found that the risk of MRD increased twofold (P = .04) when renal RI was >=0.63. Conclusions: A reduction in creatinine clearance and the presence of microalbuminuria are associated with increased renal vascular impedence, as well as with signs of extrarenal arterial stiffness. Am J Hypertens 2005;18: 966–971 © 2005

Mild renal dysfunction and renal vascular resistance in primary hypertension

DERCHI, LORENZO;LEONCINI, GIOVANNA;VIAZZI, FRANCESCA CHIARA;MARTINOLI, CARLO;DEFERRARI, GIACOMO;PONTREMOLI, ROBERTO
2005

Abstract

Background: Mild renal dysfunction (MRD) is an often overlooked but relatively common condition in patients with primary hypertension (PH), and is associated with high cardiovascular morbidity and mortality. Whether MRD is also associated with abnormalities in renal vascular resistance is currently unknown. Methods: Two hundred ninety-one untreated patients with PH were studied. The MRD was defined as a creatinine clearance>=60 mL/min but <90 mL/min (Cockcroft-Gault formula) or the presence of microalbuminuria. Albuminuria was measured as the albumin-to-creatinine ratio in first morning urine samples. Renal resistive index (RI) was evaluated by ultrasound Doppler of the interlobar arteries. Results: The prevalence of MRD in our cohort was 63%. Patients with MRD were older, had higher mean blood pressure (BP), pulse pressure, and total cholesterol, longer history of hypertension, and were more likely to be men. Renal RI was positively related to female gender, age, systolic BP, pulse pressure, total cholesterol, albuminuria, and to carotid wall thickness and cross-sectional area, whereas it was inversely related to diastolic BP and creatinine clearance. Patients with the highest renal resistance (upper quartile,>=0.63) showed a greater prevalence of renal dysfunction (P = .0005). After adjusting for age, pulse pressure, and LDLcholesterol, we found that the risk of MRD increased twofold (P = .04) when renal RI was >=0.63. Conclusions: A reduction in creatinine clearance and the presence of microalbuminuria are associated with increased renal vascular impedence, as well as with signs of extrarenal arterial stiffness. Am J Hypertens 2005;18: 966–971 © 2005
File in questo prodotto:
File Dimensione Formato  
2005 AJH RI and MRD.pdf

accesso chiuso

Tipologia: Documento in versione editoriale
Dimensione 123.44 kB
Formato Adobe PDF
123.44 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11567/267209
Citazioni
  • ???jsp.display-item.citation.pmc??? 12
  • Scopus 62
  • ???jsp.display-item.citation.isi??? 57
social impact