The Relationship Between Renal Arterial Resistive Index (RRI) and Renal Outcomes in Patients with Resistant Hypertension.

INTRODUCTION: There is a mutual relationship between hypertension and renal failure, so that hypertension can be considered as a common finding in patients with end-stage renal disorders. Patients with persistent hypertension despite multiple medications are at high risk for adverse cardiovascular and kidney events. Some studies suggest that there is a correlation between RI and renal function in kidney diseases. Therefore, we conducted a study to investigate the relationship between renal arterial resistive index (RRI) and renal outcomes in patients with resistant hypertension. METHODS: This 2-years cross-sectional study was performed on patients with resistant hypertension. All patients undergo GFR, serum Cr and urine Alb tests. Then Doppler ultrasound was performed by a radiologist to measure RRI and was evaluated for the relationship between RRI and renal function. RESULTS: Among 133 patients with resistant hypertension, 57.5% were male and the rest were female. Average age of participants and average RI were 48.26 ± 16.90 and 0.63 ± 0.80, respectively. There was no significant relationship between RI and gender (P > .05). Relationship between RI index with age, GFR, serum creatinine level, and albuminuria was significant in all cases (P < .05). Patients were divided into two groups with RI ≥ 0.7 and RI less than 0.7. Results showed a significant increase in serum creatinine and urinary albumin excretion in group with RI ≥ 0.7 (P < .05), while age, protein exertion level, and GFR in the two groups were not statistically significant (P > .05), despite the difference in the mean. Results of analysis of difference in the mean RI in 3 groups (macro-, micro-, normo- albuminuria) showed no significant difference between them (P > .05). CONCLUSION: These data demonstrate the clinical importance of renal Doppler that may be an effective way to evaluate the prognosis of renal involvement in resistant hypertension.

The Survey of Relationship Between Resistance Index of Renal Artery and Albuminuria in Diabetic Patients Referring to Shahid Sayyad Shirazi Hospital, 2017 to 2018.

INTRODUCTION: The Resistance Index by doppler ultrasound has been characterized as a non-invasive diagnostic method that has been well predictive of the outcome of renal function in type 2 diabetic patients. This study aims to investigate the relationship between renal artery resistance index (RI) and albuminuria in diabetic patients. METHODS: This descriptive, analytical, cross-sectional study was conducted on diabetic patients referred to the clinic for ultrasonography. Patients were divided into two groups: macro albuminuria and microalbuminuria or normoalbuminuria and for all patients, ultrasonography was done using the same ultrasound machine and by the same operator. Doppler sonography of the renal arteries was performed and the results were recorded. RESULTS: 52.4% of the patients were female. The mean age of these patients was 50.25 ± 16.41. The mean RI in the study population was 66.0 ± 0.01. In this study, RI with albuminuria and HbA1c levels in diabetic patients were not significant. However, there was a significant relationship between RI and serum creatinine in diabetic patients, with increasing creatinine level, RI was also increased. Also, there was a significant relationship between RI and gender and this indicator had a direct relation with male gender but there was no correlation with female gender. CONCLUSION: In the current study, the patient's albuminuria, type of treatment and HbA1c had no effect on the RI. The study also found that an increase in the RI index could be a significant predictor of renal dysfunction and increased creatinine.

Comparison of Gabapentin and Ketotifen in Treatment of Uremic Pruritus in Hemodialysis Patients.

OBJECTIVES: Uremic pruritus is a common problem in hemodialysis patients. Several treatments have been used for decreasing itching in these patients. Gabapentin and ketotifen are two drugs used for treating uremic patients. The aim of this study was to compare gabapentin and ketotifen in treatment of uremic pruritus in hemodialysis patients. METHODS: In this double-blind randomized clinical trial, 52 hemodialysis patients with uremic pruritus referred to 5azarTeaching Hospital in Gorgan in 2013 were studied. Patients were randomly assigned to two groups of 26 subjects (groups G and K). In group G, patients treated with gabapentin capsules 100 mg daily for 2 weeks, and in Group K, patients treated with ketotifen 1 mg twice daily for 2 weeks. Before and at the end of study, pruritus severity was determined based on Shiratori's severity scores. Collected data were analyzed by SPSS-21 statistical software. RESULTS: There was no significant different between two groups in the age and sex. After two weeks of treatment, severity of pruritus was significantly reduced in both groups (88.4% in group G vs. 76.9% in group K). Gabapentin compared with ketotifen had a better effect on improving itching in the age group of 30-60 years and in males. 5 patients (19.2%) in both groups suffered from drowsiness and dizziness, but no serious side effects were observed. CONCLUSIONS: The results showed that gabapentin and ketotifen significantly improved pruritus in hemodialysis patients, and no significant difference was observed between two groups.