Measurement of the intrarenal arterial resistance index for the identification and prediction of diabetic nephropathy(971 views) Masulli M, Mancini M, Liuzzi R, Daniele S, Mainenti PP, Vergara E, Genovese S, Salvatore M, Vaccaro O
Keywords: 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,
Affiliations: *** 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
References: Not available.
Measurement of the intrarenal arterial resistance index for the identification and prediction of diabetic nephropathy
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
Measurement of the intrarenal arterial resistance index for the identification and prediction of diabetic nephropathy
No results.
Measurement of the intrarenal arterial resistance index for the identification and prediction of diabetic nephropathy