Dynamic evaluation of renal resistive index in normoalbuminuric patients with newly diagnosed hypertension or type 2 diabetes.
Diabetologia
; 54(9): 2430-9, 2011 Sep.
Article
in En
| MEDLINE
| ID: mdl-21499674
ABSTRACT
AIM/HYPOTHESIS:
Renal resistive index is a useful measure for quantifying alterations in renal blood flow. In the present study we evaluated resistive index at baseline and after vasodilation induced by nitroglycerine in normoalbuminuric patients with type 2 diabetes or essential hypertension, relating the values to indices of systemic vascular dysfunction.METHODS:
Newly diagnosed treatment-naïve type 2 diabetic (n = 32) and hypertensive patients (n = 49) were compared with 27 age- and sex-matched healthy controls. Renal resistive index was obtained by duplex ultrasound at baseline and after 25 µg sublingual nitroglycerine. Endothelium-dependent (flow-mediated dilation) and -independent (response to nitroglycerine) vasodilation in the brachial artery was assessed by computerised edge detection system. Carotid-femoral pulse-wave velocity and augmentation index were assessed by applanation tonometry. Nitrotyrosine levels, an index of oxidative stress, were also measured.RESULTS:
Resistive index was higher in diabetic than in hypertensive patients and controls (p < 0.001), while changes in resistive index induced by nitroglycerine were lower in hypertensive patients compared with controls (p < 0.01), and were further reduced in type 2 diabetic patients. Hypertensive and diabetic patients showed significantly increased arterial stiffness, nitrotyrosine levels and reduced endothelial function than controls (p < 0.05). Changes in resistive index induced by nitroglycerine were independently related to serum glucose, reactive hyperaemia and aortic pulse-wave velocity in the overall population. CONCLUSIONS/INTERPRETATION:
These results support the dynamic evaluation of renal resistive index as an early detector of renal vascular alterations in the presence of type 2 diabetes and hypertension, even before the onset of microalbuminuria.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Regional Blood Flow
/
Diabetes Mellitus, Type 2
/
Albuminuria
/
Hypertension
/
Kidney
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Diabetologia
Year:
2011
Document type:
Article
Affiliation country:
Italy