Renal duplex parameters, blood pressure, and renal function in elderly people.
BACKGROUND
Changes in renal artery and renal parenchyma perfusion are believed to correlate with severity of hypertension and worsened renal function, but population-based studies of these associations are not available. This study examines relationships between parameters derived from renal duplex sonography (RDS), blood pressure (BP), and excretory renal function in a population-based cohort of elderly Americans.


METHODS
Through an ancillary study to the Cardiovascular Health Study, 758 participants (37% men; mean age, 77 years) underwent RDS in which flow velocities and frequency shifts were determined from spectral analysis of Doppler-shifted signals obtained from the renal artery and parenchyma. Associations of these duplex parameters with BP and inverse serum creatinine were examined by using multivariate regression techniques.


RESULTS
Main renal artery peak systolic flow velocity (PSV) showed independent associations with BP, with an SD increase in PSV (0.53 m/s) associated with a 3.3-mm Hg increase in systolic BP (SBP) and a 2.4-mm Hg decrease in diastolic BP (DBP). An SD decrease in end-diastolic frequency shift (EDF; 131 kHz) was associated with a 6.0-mm Hg increase in SBP, a 4.2-mm Hg decrease in DBP, and a significant 3.7% decrease in inverse serum creatinine.


CONCLUSIONS
Increases in renal artery PSV and decreases in parenchymal EDF are associated with increased SBP and decreased DBP. Moreover, decreased parenchymal EDF showed significant associations with impaired excretory renal function. These results suggest that renal duplex parameters are associated with renal parenchymal changes caused by hypertension and progressive renal dysfunction in elderly people.
Pearce
Jeffrey D
JD
Division of Surgical Sciences, Section on Vascular Surgery, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1095, USA.
Edwards
Matthew S
MS
Craven
Timothy E
TE
English
William P
WP
Mondi
Matthew M
MM
Reavis
Scott W
SW
Hansen
Kimberley J
KJ
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000375:Aging / Q000502:physiology; D001161:Arteriosclerosis / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003971:Diastole; D018450:Disease Progression; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000453:epidemiology / Q000209:etiology; D007668:Kidney / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging; D012079:Renal Circulation; D012307:Risk Factors; D012494:Sampling Studies; D013599:Systole; D018616:Ultrasonography, Doppler, Duplex; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D003404:Creatinine