title: Intrarenal arterial resistance is associated with microvascular complications in Chinese type 2 diabetic patients.
abstract: BACKGROUND
  Increased renal arterial resistance is associated with various types of chronic renal parenchymal diseases. A resistance index (RI) > 0.8 predicts deterioration in renal function in diabetic subjects. However, the association between renal RI and other diabetic complications has not been investigated. In this study, we examined the association between intrarenal arterial RI and diabetic complications in Chinese type 2 diabetic subjects.
  
  
  METHODS
  Three hundred and eighty-seven Chinese type 2 diabetic patients were recruited from a structured assessment programme to evaluate their risk factors and complications as a part of the quality improvement programme at the Prince of Wales Hospital. All subjects underwent ultrasound examinations for the assessment of intrarenal arterial RI of both kidneys. Clinical and biochemical parameters, including diabetes-related microvascular complications (nephropathy, retinopathy and sensory neuropathy) and macrovascular diseases, were examined.
  
  
  RESULTS
  The mean RI of patients with any microvascular complications (0.70 ± 0.09 versus 0.65 ± 0.06) such as nephropathy (0.71 ± 0.09 versus 0.66 ± 0.06), retinopathy (0.71 ± 0.08 versus 0.67 ± 0.08) and sensory neuropathy (0.75 ± 0.07 versus 0.68 ± 0.08) and with any macrovascular complications (0.71 ± 0.09 versus 0.68 ± 0.08) was higher than those without (P < 0.05). On multivariate analysis, after controlling for confounding variables, an RI ≥0.75 was associated with microvascular complications, nephropathy, retinopathy and sensory neuropathy, with odds ratio of 4.02 [95% confidence interval (CI) 1.72-9.4], 4.99 (2.61-9.56), 2.78 (1.52-5.09) and 5.74 (1.8-18.3), respectively. The association of RI with macrovascular complications was not significant in multivariate analysis.
  
  
  CONCLUSIONS
  Increased intrarenal arterial resistance was independently associated with an increased risk of microvascular complications including diabetic nephropathy, diabetic retinopathy and diabetic sensory neuropathy in Chinese type 2 diabetic patients.
authors.affiliation: 1Department of Imaging and Interventional Radiology, The ChineseUniversity of Hong Kong, Hong Kong, China.
authors.forename: Kin Hung
authors.initials: KH
authors.lastname: Liu
authors.forename: Winnie Chiu Wing
authors.initials: WC
authors.lastname: Chu
authors.forename: Alice Pik Shan
authors.initials: AP
authors.lastname: Kong
authors.forename: Gary Tin Choi
authors.initials: GT
authors.lastname: Ko
authors.forename: Ronald Ching Wan
authors.initials: RC
authors.lastname: Ma
authors.forename: Jeff Wai Sang
authors.initials: JW
authors.lastname: Chan
authors.forename: Wing Yee
authors.initials: WY
authors.lastname: So
authors.forename: Andrea O Y
authors.initials: AO
authors.lastname: Luk
authors.forename: Kitty K T
authors.initials: KK
authors.lastname: Cheung
authors.forename: Risa
authors.initials: R
authors.lastname: Ozaki
authors.forename: Anil T
authors.initials: AT
authors.lastname: Ahuja
authors.forename: Juliana Chung Ngor
authors.initials: JC
authors.lastname: Chan
mesh_terms: D000368:Aged; D048909:Diabetes Complications / Q000209:etiology / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000209:etiology / Q000473:pathology*; D003929:Diabetic Neuropathies / Q000209:etiology / Q000473:pathology*; D003930:Diabetic Retinopathy / Q000209:etiology / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014655:Vascular Resistance