title: Association of renal resistive index with target organ damage in essential hypertension.
abstract: BACKGROUND
  The renal resistive index (RI) measured using Doppler ultrasonography has been used as a diagnostic tool in the daily work-up of kidney diseases. A better understanding of its relationship with preclinical organ damage may help in determining overall cardiovascular risk in hypertensive patients.
  
  
  METHODS
  We evaluated the association between RI and the presence and degree of target organ damage (TOD) in 288 (130 male) essential hypertensive patients. RI, carotid intima-media thickness (IMT), and left ventricular (LV) mass index were assessed by ultrasound scan. Albuminuria was measured as the albumin-to-creatinine ratio (ACR) in three consecutive first morning urine samples.
  
  
  RESULTS
  In univariate analysis, patients with TOD showed significantly higher RI as compared with those without TOD (presence vs. absence of carotid wall thickening, LV hypertrophy, and albuminuria, P < 0.01, respectively). The severity of each TOD increased progressively from the lower to the upper RI tertile. Multiple logistic regression analysis found that each standard deviation increase in RI gave a 47% higher odds of having LV hypertrophy, and a 70% higher odds of having albuminuria (P < 0.05, respectively). The occurrence of at least two signs of TOD also significantly increased in parallel with elevation of RI (odds ratio (OR): 1.89 for 1 s.d. increase, P < 0.01).
  
  
  CONCLUSIONS
  These results suggest that increased RI may be a marker of subclinical TOD in patients with essential hypertension.
authors.affiliation: Divisions of Hypertension and Nephrology, Department of Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Doi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Iwashima
authors.forename: Fumiki
authors.initials: F
authors.lastname: Yoshihara
authors.forename: Kei
authors.initials: K
authors.lastname: Kamide
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takata
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujii
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kubota
authors.forename: Satoko
authors.initials: S
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Horio
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D015415:Biomarkers / Q000652:urine; D001783:Blood Flow Velocity; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012079:Renal Circulation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D018616:Ultrasonography, Doppler, Duplex; D014655:Vascular Resistance; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine