Changes in renal microcirculation in patients with nephrotic and nephritic syndrome: The role of resistive index

IF 2.9 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Microvascular research Pub Date : 2023-12-10 DOI:10.1016/j.mvr.2023.104641

Antonietta Gigante, Chiara Pellicano, Oriana De Marco, Eleonora Assanto, Georgia Sorato, Alberto Palladini, Edoardo Rosato, Silvia Lai, Maurizio Muscaritoli, Rosario Cianci

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引用次数: 0

Abstract

Background

Renal Resistive Index (RRI) is an important and non-invasive parameter of renal damage and it is associated with abnormal microcirculation or to a parenchymal injury. The aim of our study was to compare the RRI in a cohort of patients with renal diseases categorized in three groups: nephrotic syndrome (NS), acute nephritic syndrome (ANS) and patients with urinary abnormalities (UA).

Methods

Four hundred eighty-two patients with median age of 48 years (IQR 34–62) with indications for kidney disease were included in the study. Biochemical analyses, clinical assessment with detection of NS, ANS and UA and comorbidities were reported. Renal Doppler ultrasound with RRI was evaluated in all patients at the time of enrolment.

Results

NS was present in 81 (16.8 %) patients while ANS in 81 (16.8 %) and UA in 228 (47.3 %) patients. Patients with ANS showed significant higher RRI compared to both patients with NS [0.71 (IQR 0.67–0.78) vs 0.68 (0.63–0.73), p < 0.001] and UA [0.71 (0.67–0.78) vs 0.65 (0.61–0.71), p < 0.001]; RRI was higher in NS patients than in patients with UA [0.68 (0.63–0.73) vs 0.65 (0.61–0.71), p < 0.001]. Patients with ANS had significantly lower median estimated glomerular filtration rate (eGFR) compared respectively to NS and UA patients [19.7 ml/min vs 54.8 ml/min and vs 72.3 ml/min, p < 0.001], while renal length was significantly higher in patients with NS compared to both patients with ANS and UA [111.88 mm vs 101.98 mm and vs 106.15, p < 0.001]. Patients with ANS had more frequently hematuria and RRI ≥ 0.70 (p < 0.001) compared to both patients with NS and patients with UA. The multiple regression analysis, weighted for age, showed that RRI inversely correlates with eGFR (β coefficient = −0.430, p < 0.001).

Conclusions

Higher and pathological RRI were found in ANS than NS and UA. Renal resistive index in ANS reflects changes in intrarenal perfusion and microvascular dysfunction related to disease characteristics.

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肾病和肾炎综合征患者肾微循环的变化：阻力指数的作用

背景肾脏阻力指数（Renal Resistive Index，RRI）是肾脏损伤的一个重要非侵入性参数，它与微循环异常或肾实质损伤有关。我们的研究旨在比较一组肾病患者的 RRI，这些患者分为三组：肾病综合征（NS）、急性肾炎综合征（ANS）和泌尿系统异常（UA）患者。研究报告包括生化分析、临床评估、NS、ANS 和 UA 检测以及合并症。结果81例（16.8%）患者出现NS，81例（16.8%）患者出现ANS，228例（47.3%）患者出现UA。与 NS [0.71 (IQR 0.67-0.78) vs 0.68 (0.63-0.73), p < 0.001]和 UA [0.71 (0. 67-0.78) vs 0.68 (0.63-0.73), p < 0.001]患者相比，ANS 患者的 RRI 明显更高。67-0.78) vs 0.65 (0.61-0.71), p <0.001]；NS 患者的 RRI 高于 UA 患者[0.68 (0.63-0.73) vs 0.65 (0.61-0.71), p <0.001]。ANS患者的估计肾小球滤过率（eGFR）中位数明显低于NS和UA患者[19.7 ml/min vs 54.8 ml/min and vs 72.3 ml/min, p <0.001]，而NS患者的肾长度明显高于ANS和UA患者[111.88 mm vs 101.98 mm and vs 106.15, p <0.001]。与 NS 和 UA 患者相比，ANS 患者更常出现血尿且 RRI ≥ 0.70 (p < 0.001)。根据年龄加权的多元回归分析表明，RRI 与 eGFR 成反比（β 系数 = -0.430，p < 0.001）。ANS的肾阻力指数反映了与疾病特征相关的肾内灌注和微血管功能障碍的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microvascular research 医学-外周血管病

CiteScore

6.00

自引率

3.20%

发文量

158

审稿时长

43 days

期刊介绍： Microvascular Research is dedicated to the dissemination of fundamental information related to the microvascular field. Full-length articles presenting the results of original research and brief communications are featured. Research Areas include: • Angiogenesis • Biochemistry • Bioengineering • Biomathematics • Biophysics • Cancer • Circulatory homeostasis • Comparative physiology • Drug delivery • Neuropharmacology • Microvascular pathology • Rheology • Tissue Engineering.