Resistive index as a predictor of renal progression in patients with moderate renal dysfunction regardless of angiotensin converting enzyme inhibitor or angiotensin receptor antagonist medication|RISS 상세보기

다국어 초록 (Multilingual Abstract)

Background: Previous studies have shown that a higher resistive index (RI) on renal duplex ultrasonography was related with renal progression and acute kidney injury, especially in patients with chronic kidney disease (CKD) using an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist (ARB). We evaluated whether a RI value is a predictive factor for renal progression regardless of ACEI or ARB medication in patients with moderate renal dysfunction.
Methods: We retrospectively analyzed 119 patients with moderate renal dysfunction that had been evaluated with renal duplex ultrasonography from February 2011 to April 2015. Moderate renal dysfunction was defined as a stage 3 to 4 CKD. Renal progression was defined as a doubling of the baseline serum creatinine (sCr), a decrease of baseline glomerular filtration rate by > 50%, or initiation of renal replacement therapy.
Results: The mean age was 64.7 ± 11.0 years and sCr level was 2.1 ± 1.2 mg/dL. The RI ≥ 0.79 group showed a higher incidence of renal progression (P = 0.004, log-rank test) compared with the RI < 0.79 group, irrespective of ACEI or ARB usage. In the Cox proportional hazard model, RI ≥ 0.79 was an independent prognostic factor after adjusting for age, sex, diabetes mellitus, sCr, proteinuria, and use of ACEI or ARB (hazard ratio, 4.88; 95% confidence interval, 1.06-22.53; P = 0.043).
Conclusion: RI ≥ 0.79 on the renal duplex ultrasonography can be a helpful predictor for renal progression in patients with moderate renal dysfunction, regardless of their ACEI or ARB usage.

번역하기

참고문헌 (Reference)

1 Levey AS, "Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate" 145 : 247-254, 2006

2 Kawai T, "Usefulness of the resistive index in renal Doppler ultrasonography as an indicator of vascular damage in patients with risks of atherosclerosis" 26 : 3256-3262, 2011

3 Bader R, "Structure and function of the kidney in diabetic glomerulosclerosis. Correlations between morphological and functional parameters" 167 : 204-216, 1980

4 Cooper CJ, "Stenting and medical therapy for atherosclerotic renal-artery stenosis" 370 : 13-22, 2014

5 Bax L, "Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function: a randomized trial" 150 : 840-848, 2009

6 Daijo Inaguma, "Risk factors for CKD progression in Japanese patients: findings from the Chronic Kidney Disease Japan Cohort (CKD-JAC) study" Springer Nature 21 (21): 446-456, 2017

7 ASTRAL Investigators, "Revascularization versus medical therapy for renal-artery stenosis" 361 : 1953-1962, 2009

8 Sugiura T, "Resistive index predicts renal prognosis in chronic kidney disease" 24 : 2780-2785, 2009

9 김은석, "Resistive index as a predictor of acute kidney injury caused by an angiotensin converting enzyme inhibitor or angiotensin II receptor blocker in chronic kidney disease patients" 대한신장학회 32 (32): 158-163, 2013

10 Raff U, "Renal resistive index in addition to low-grade albuminuria complements screening for target organ damage in therapy-resistant hypertension" 28 : 608-614, 2010