Measurement of the intrarenal arterial resistance index for the identification and prediction of diabetic nephropathy(154 visite) Masulli M, Mancini M, Liuzzi R, Daniele S, Mainenti PP, Vergara E, Genovese S, Salvatore M, Vaccaro O
Parole chiave: Diabetic Nephropathy, Microalbuminuria, Renal Resistance Index, Type 2 Diabetes, Adult, Aged, Article, Case Control Study, Disease Course, Echography, Female, Follow Up, Glomerulus Filtration Rate, Human, Hypertension, Kidney, Kidney Function Test, Middle Aged, Non Insulin Dependent Diabetes Mellitus, Prediction And Forecasting, Prospective Study, Risk Factor, Vascular Resistance, Vascularization, Case-Control Studies, Diabetic Nephropathies, Disease Progression, Follow-Up Studies, Glomerular Filtration Rate, Odds Ratio, Predictive Value Of Tests, Prospective Studies, Time Factors,
Affiliazioni:
*** IBB - CNR *** Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy Institute of Biostructure and Bioimage, National Council of Research (CNR), Naples, Italy Department of Biomorphological and Functional Science, Federico II University, Naples, Italy
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Tublin, M. E., Bude, R. O., Platt, J. F., The resistive index in renal Doppler sonography: where do we stand? (2003) AJR Am J Roentgenol, 180
Petersen, L. J., Petersen, J. R., Talleruuphus, U., Ladefoged, S. D., Mehelsen, J., Jensen, H. A., The pulsatility index and the resistive index in renal arteries: association with long-term progression in chronic renal failure (1997) Nephrol Dial Transplant, 12, pp. 1376-1380
Levey, A. S., Bosch, J. P., Lewis, J. B., Greene, T., Rogers, N., Roth, D., A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group (1999) Ann Intern Med, 130, pp. 461-470
Levey, A. S., Greene, T., Kusek, J. W., Beck, G. J., A simplified equation to predict glomerular filtration rate from serum creatinine (2000) J Am Soc Nephrol, 11, pp. 155A
(1986) SPSS user's guide, , Mc Graw Hill, New York
Stratton, I. M., Adler, A. I., Neil, H. A., Matthews, D. R., Manley, S. E., Cull, C. A., Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study (2000) BMJ, 321 (7258), pp. 405-412
Wang, P. H., Lau, J., Chalmers, T. C., Meta-analysis of effects of intensive blood glucose control on late complications of type 1 diabetes (1993) Lancet, 341, pp. 1306-1309
Adler, A. I., Stratton, I. M., Neil, H. A., Yudkin, J. S., Matthews, D. R., Cull, C. A., Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study (2000) BMJ, 321 (7258), pp. 412-419
Casas, J. P., Chua, W., Loukogeorgakis, S., Vallance, P., Smeeth, L., Hingorani, A. D., Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: systematic review and meta-analysis (2005) Lancet, 366 (9502), pp. 2026-2033
Heine, G. H., Reichart, B., Ulrich, C., Kohler, H., Girndt, M., Do ultrasound renal resistance indices reflect systemic rather than renal vascular damage in chronic kidney disease? (2007) Nephrol Dial Transplant, 22 (1), pp. 163-170
Background and Aims: High intrarenal resistance index (RI) predicts renal function in several conditions; its use in the prediction of diabetic nephropathy (DN) is little explored. We aimed (1) to compare RI in diabetic and non diabetic hypertensive patients, and (2) to evaluate whether high RI is associated with clinical signs of DN and its progression over time. Methods and Results: Design: observational, prospective. Participants: 92 type 2 diabetic patients and 37 non-diabetic controls aged 40-70, with hypertension and normal renal function. We measured ultrasound RI and, among others, creatinine, estimated glomerular filtration rate and urinary albumin excretion rate (AER) at baseline and after 4.5 years follow-up. Progression of albuminuric state (i.e., transition from baseline normo-microalbuminuria to follow-up micro-macroalbuminuria) was evaluated. RI was significantly higher in diabetic than non-diabetic participants (0.69 ± 0.05 vs 0.59 ± 0.05, p < 0.001). Diabetic patients with RI ≥ 0.73, i.e., above the 80th percentile of the RI distribution, had significantly higher baseline AER and a more frequent progression of the albuminuric state compared to patients with RI < 0.73 (27.7 μg/mg [12.1-235.4] vs 15.1 μg/mg [8.6-33.4]; 52.9% vs 9.5%, respectively). AER increased significantly from baseline to follow-up in patients with RI ≥ 0.73 (from 27.7 μg/mg [12.1-235.4] to 265.0 μg/mg [23.8-1018.1], p < 0.01), but not in those with RI < 0.73 (from 15.1 μg/mg [8.6-33.4] to 16.1 μg/mg [10.7-67.2], ns). OR for progression of albuminuric state, adjusted for established predictors of DN, including baseline AER, was 5.01 (1.4-17.7, 95% CI) for patients with RI ≥ 0.73 vs
136 Records (124 escludendo Abstract e Conferenze). Impact factor totale: 404.615 (364.11 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 396.443 (357.709 escludendo Abstract e Conferenze).
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