title: Predictive role of renal resistive index for clinical outcome after revascularization in hypertensive patients with atherosclerotic renal artery stenosis: a monocentric observational study.
abstract: BACKGROUND
  The present study evaluated the predictive value of renal resistive index (RI) for renal function and blood pressure (BP) outcome in hypertensive patients with unilateral atherosclerotic renal artery stenosis submitted to successful revascularization.
  
  
  METHODS
  In 158 hypertensive patients with atherosclerotic renal artery stenosis RI was acquired. Twelve months after revascularization, they were classified on the basis of renal function and BP outcome as benefit (BP < 140/90 mmHg or diastolic BP reduction > 15 mmHg with the same of reduced drugs; decrease in glomerular filtration rate > 20%), or failure.
  
  
  RESULTS
  Regarding renal function outcome, RI in the stenotic and in the contralateral kidney were significantly higher in patients with failure (n = 20) than in those with benefit (0.72 ± 0.11 vs 0.61 ± 0.11 and 0.76 ± 0.08 vs 0.66 ± 0.09, p < 0.05). Among different cutpoints generated, RI in the contralateral kidney >0.73 provided the largest area under the curve (0.77), and the highest sensitivity (80%) and specificity (72%). In the multivariate logistic regression analysis, RI in the contralateral kidney >0.73 was an independent predictor of a failure in renal function outcome.Regarding BP outcome, patients with no benefit from revascularization (n = 60) had similar RI in the stenotic and contralateral kidney (p = ns), but presented higher pulse pressure, albuminuria and hypertension duration in comparison to patients with improved BP control.
  
  
  CONCLUSIONS
  RI in the contralateral kidney is an independent predictor of renal function outcome after successful revascularization in hypertensive patients with unilateral atherosclerotic renal artery stenosis, whereas it is not able to predict blood pressure outcome.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. rosam.bruno@gmail.com.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Bruno
authors.forename: Elena
authors.initials: E
authors.lastname: Daghini
authors.forename: Daniele
authors.initials: D
authors.lastname: Versari
authors.forename: Melania
authors.initials: M
authors.lastname: Sgrò
authors.forename: Michela
authors.initials: M
authors.lastname: Sanna
authors.forename: Luigi
authors.initials: L
authors.lastname: Venturini
authors.forename: Caterina
authors.initials: C
authors.lastname: Romanini
authors.forename: Irene
authors.initials: I
authors.lastname: Di Paco
authors.forename: Isabella
authors.initials: I
authors.lastname: Sudano
authors.forename: Roberto
authors.initials: R
authors.lastname: Cioni
authors.forename: Lilach O
authors.initials: LO
authors.lastname: Lerman
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ghiadoni
authors.forename: Stefano
authors.initials: S
authors.lastname: Taddei
authors.forename: Stefania
authors.initials: S
authors.lastname: Pinto
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D054459:Elasticity Imaging Techniques / Q000379:methods; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D009204:Myocardial Revascularization; D011379:Prognosis; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014655:Vascular Resistance