Renal Resistance Index and Progression of Renal Disease

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2002-02, Vol.39 (2, Part 2 Suppl), p.699-703
• Main Authors: Radermacher, Jörg, Ellis, Sebastian, Haller, Hermann
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Disease Progression; Humans; Kidney Diseases - diagnostic imaging; Kidney Diseases - pathology; Kidney Diseases - physiopathology; Kidney Function Tests; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Renovascular diseases; Ultrasonography
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/hy0202.103782

The progression of renal disease depends on various clinical parameters such as hypertension and proteinuria. We recently showed that an increased renal resistance index measured by duplex ultrasound is associated with a poor prognosis in patients with renal artery stenosis. We now prospectively tested the hypothesis that a high renal resistance index (≥80) predicts progression of renal disease in patients without renal artery stenosis. In 162 patients newly diagnosed with renal disease, the resistance index (1−[enddiastolic velocity/maximum systolic velocity]*100) was measured in segmental arteries of both kidneys. Creatinine clearance was measured at baseline, at 3, 6, and 12 months, and then at yearly intervals thereafter (mean follow-up 3±1.4 years). The combined endpoint was a decrease of creatinine clearance by ≥50%, end-stage renal disease with replacement therapy, or death. Twenty-five patients (15%) had a renal resistance index value ≥80 at baseline. Nineteen (76%) had a decline in renal function; 16 (64%) progressed to dialysis, and 6 (24%) died. In comparison, in patients with renal resistance index values