title: Impact of cardiovascular organ damage on cortical renal perfusion in patients with chronic renal failure.
abstract: BACKGROUND
  Properly preserved renal perfusion is the basic determinant of oxygenation, vitality, nutrition, and organ function and its structure. Perfusion disorders are functional changes and are ahead of the appearance of biochemical markers of organ damage. The aim of this study was to evaluate a relationship between the renal cortex perfusion and markers of cardiovascular organ damage in patients with stable chronic renal failure (CKD).
  
  
  METHODS
  Seventeen patients (2 F; 15 M; age 47 ± 16) with stable CKD at 2-4 stages and hypertension or signs of heart failure were enrolled in this study. Blood tests with an estimation of renal and cardiac functions, echocardiographic parameters, intima-media thickness (IMT), renal resistance index (RRI), and total (TPI), proximal (PPI), and distal (DPI) renal cortical perfusion intensity measurements were collected.
  
  
  RESULTS
  DPI was significantly lower than PPI. TPI significantly correlated with age, Cys, CKD-EPI (cystatin), and IMT, whereas DPI significantly depended on Cystain, CKD-EPI (cystatin; cystatin-creatinine), IMT, NT-proBNP, and troponin I. In multiple stepwise regression analysis model only CKD-EPI (cystatin) independently influenced DPI.
  
  
  CONCLUSIONS
  Cardiovascular and kidney damage significantly influences renal cortical perfusion. Ultrasound measurement of renal perfusion could be a sensitive method for early investigation of cardiovascular and renal injuries.
authors.affiliation: Department of Internal Diseases, Nephrology, and Dialysis, Military Institute of Medicine, Warsaw 44, Poland. alubas@wim.mil.pl
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Lubas
authors.forename: Robert
authors.initials: R
authors.lastname: Ryczek
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kade
authors.forename: Jerzy
authors.initials: J
authors.lastname: Smoszna
authors.forename: Stanisław
authors.initials: S
authors.lastname: Niemczyk
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory; D002319:Cardiovascular System / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006403:Hematologic Tests; D006801:Humans; D007672:Kidney Cortex / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000473:pathology* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010477:Perfusion