Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis

A monocentric observational study

Rosa Maria Bruno, Elena Daghini, Daniele Versari, Melania Sgrò, Michela Sanna, Luigi Venturini, Caterina Romanini, Irene Di Paco, Isabella Sudano, Roberto Cioni, Lilach O Lerman, Lorenzo Ghiadoni, Stefano Taddei, Stefania Pinto

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: The present study evaluated the predictive value of renal resistive index (RI) for renal function and blood pressure (BP) outcome in hypertensive patients with unilateral atherosclerotic renal artery stenosis submitted to successful revascularization. Methods. In 158 hypertensive patients with atherosclerotic renal artery stenosis RI was acquired. Twelve months after revascularization, they were classified on the basis of renal function and BP outcome as benefit (BP < 140/90 mmHg or diastolic BP reduction > 15 mmHg with the same of reduced drugs; decrease in glomerular filtration rate > 20%), or failure. Results: Regarding renal function outcome, RI in the stenotic and in the contralateral kidney were significantly higher in patients with failure (n = 20) than in those with benefit (0.72 ± 0.11 vs 0.61 ± 0.11 and 0.76 ± 0.08 vs 0.66 ± 0.09, p < 0.05). Among different cutpoints generated, RI in the contralateral kidney >0.73 provided the largest area under the curve (0.77), and the highest sensitivity (80%) and specificity (72%). In the multivariate logistic regression analysis, RI in the contralateral kidney >0.73 was an independent predictor of a failure in renal function outcome. Regarding BP outcome, patients with no benefit from revascularization (n = 60) had similar RI in the stenotic and contralateral kidney (p = ns), but presented higher pulse pressure, albuminuria and hypertension duration in comparison to patients with improved BP control. Conclusions: RI in the contralateral kidney is an independent predictor of renal function outcome after successful revascularization in hypertensive patients with unilateral atherosclerotic renal artery stenosis, whereas it is not able to predict blood pressure outcome.

Original languageEnglish (US)
Article number9
JournalCardiovascular Ultrasound
Volume12
Issue number1
DOIs
StatePublished - Feb 20 2014

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Renal Artery Obstruction
Observational Studies
Kidney
Blood Pressure
Albuminuria
Glomerular Filtration Rate
Area Under Curve
Renal Insufficiency
Logistic Models
Regression Analysis
Hypertension
Sensitivity and Specificity

Keywords

  • Hypertension
  • Renal artery stenosis
  • Resistive index
  • Revascularization
  • Ultrasound

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis : A monocentric observational study. / Bruno, Rosa Maria; Daghini, Elena; Versari, Daniele; Sgrò, Melania; Sanna, Michela; Venturini, Luigi; Romanini, Caterina; Di Paco, Irene; Sudano, Isabella; Cioni, Roberto; Lerman, Lilach O; Ghiadoni, Lorenzo; Taddei, Stefano; Pinto, Stefania.

In: Cardiovascular Ultrasound, Vol. 12, No. 1, 9, 20.02.2014.

Research output: Contribution to journalArticle

Bruno, RM, Daghini, E, Versari, D, Sgrò, M, Sanna, M, Venturini, L, Romanini, C, Di Paco, I, Sudano, I, Cioni, R, Lerman, LO, Ghiadoni, L, Taddei, S & Pinto, S 2014, 'Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis: A monocentric observational study', Cardiovascular Ultrasound, vol. 12, no. 1, 9. https://doi.org/10.1186/1476-7120-12-9
Bruno, Rosa Maria ; Daghini, Elena ; Versari, Daniele ; Sgrò, Melania ; Sanna, Michela ; Venturini, Luigi ; Romanini, Caterina ; Di Paco, Irene ; Sudano, Isabella ; Cioni, Roberto ; Lerman, Lilach O ; Ghiadoni, Lorenzo ; Taddei, Stefano ; Pinto, Stefania. / Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis : A monocentric observational study. In: Cardiovascular Ultrasound. 2014 ; Vol. 12, No. 1.
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abstract = "Background: The present study evaluated the predictive value of renal resistive index (RI) for renal function and blood pressure (BP) outcome in hypertensive patients with unilateral atherosclerotic renal artery stenosis submitted to successful revascularization. Methods. In 158 hypertensive patients with atherosclerotic renal artery stenosis RI was acquired. Twelve months after revascularization, they were classified on the basis of renal function and BP outcome as benefit (BP < 140/90 mmHg or diastolic BP reduction > 15 mmHg with the same of reduced drugs; decrease in glomerular filtration rate > 20{\%}), or failure. Results: Regarding renal function outcome, RI in the stenotic and in the contralateral kidney were significantly higher in patients with failure (n = 20) than in those with benefit (0.72 ± 0.11 vs 0.61 ± 0.11 and 0.76 ± 0.08 vs 0.66 ± 0.09, p < 0.05). Among different cutpoints generated, RI in the contralateral kidney >0.73 provided the largest area under the curve (0.77), and the highest sensitivity (80{\%}) and specificity (72{\%}). In the multivariate logistic regression analysis, RI in the contralateral kidney >0.73 was an independent predictor of a failure in renal function outcome. Regarding BP outcome, patients with no benefit from revascularization (n = 60) had similar RI in the stenotic and contralateral kidney (p = ns), but presented higher pulse pressure, albuminuria and hypertension duration in comparison to patients with improved BP control. Conclusions: RI in the contralateral kidney is an independent predictor of renal function outcome after successful revascularization in hypertensive patients with unilateral atherosclerotic renal artery stenosis, whereas it is not able to predict blood pressure outcome.",
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T1 - Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis

T2 - A monocentric observational study

AU - Bruno, Rosa Maria

AU - Daghini, Elena

AU - Versari, Daniele

AU - Sgrò, Melania

AU - Sanna, Michela

AU - Venturini, Luigi

AU - Romanini, Caterina

AU - Di Paco, Irene

AU - Sudano, Isabella

AU - Cioni, Roberto

AU - Lerman, Lilach O

AU - Ghiadoni, Lorenzo

AU - Taddei, Stefano

AU - Pinto, Stefania

PY - 2014/2/20

Y1 - 2014/2/20

N2 - Background: The present study evaluated the predictive value of renal resistive index (RI) for renal function and blood pressure (BP) outcome in hypertensive patients with unilateral atherosclerotic renal artery stenosis submitted to successful revascularization. Methods. In 158 hypertensive patients with atherosclerotic renal artery stenosis RI was acquired. Twelve months after revascularization, they were classified on the basis of renal function and BP outcome as benefit (BP < 140/90 mmHg or diastolic BP reduction > 15 mmHg with the same of reduced drugs; decrease in glomerular filtration rate > 20%), or failure. Results: Regarding renal function outcome, RI in the stenotic and in the contralateral kidney were significantly higher in patients with failure (n = 20) than in those with benefit (0.72 ± 0.11 vs 0.61 ± 0.11 and 0.76 ± 0.08 vs 0.66 ± 0.09, p < 0.05). Among different cutpoints generated, RI in the contralateral kidney >0.73 provided the largest area under the curve (0.77), and the highest sensitivity (80%) and specificity (72%). In the multivariate logistic regression analysis, RI in the contralateral kidney >0.73 was an independent predictor of a failure in renal function outcome. Regarding BP outcome, patients with no benefit from revascularization (n = 60) had similar RI in the stenotic and contralateral kidney (p = ns), but presented higher pulse pressure, albuminuria and hypertension duration in comparison to patients with improved BP control. Conclusions: RI in the contralateral kidney is an independent predictor of renal function outcome after successful revascularization in hypertensive patients with unilateral atherosclerotic renal artery stenosis, whereas it is not able to predict blood pressure outcome.

AB - Background: The present study evaluated the predictive value of renal resistive index (RI) for renal function and blood pressure (BP) outcome in hypertensive patients with unilateral atherosclerotic renal artery stenosis submitted to successful revascularization. Methods. In 158 hypertensive patients with atherosclerotic renal artery stenosis RI was acquired. Twelve months after revascularization, they were classified on the basis of renal function and BP outcome as benefit (BP < 140/90 mmHg or diastolic BP reduction > 15 mmHg with the same of reduced drugs; decrease in glomerular filtration rate > 20%), or failure. Results: Regarding renal function outcome, RI in the stenotic and in the contralateral kidney were significantly higher in patients with failure (n = 20) than in those with benefit (0.72 ± 0.11 vs 0.61 ± 0.11 and 0.76 ± 0.08 vs 0.66 ± 0.09, p < 0.05). Among different cutpoints generated, RI in the contralateral kidney >0.73 provided the largest area under the curve (0.77), and the highest sensitivity (80%) and specificity (72%). In the multivariate logistic regression analysis, RI in the contralateral kidney >0.73 was an independent predictor of a failure in renal function outcome. Regarding BP outcome, patients with no benefit from revascularization (n = 60) had similar RI in the stenotic and contralateral kidney (p = ns), but presented higher pulse pressure, albuminuria and hypertension duration in comparison to patients with improved BP control. Conclusions: RI in the contralateral kidney is an independent predictor of renal function outcome after successful revascularization in hypertensive patients with unilateral atherosclerotic renal artery stenosis, whereas it is not able to predict blood pressure outcome.

KW - Hypertension

KW - Renal artery stenosis

KW - Resistive index

KW - Revascularization

KW - Ultrasound

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U2 - 10.1186/1476-7120-12-9

DO - 10.1186/1476-7120-12-9

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JO - Cardiovascular Ultrasound

JF - Cardiovascular Ultrasound

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