title: The relationship between renal resistive index, arterial stiffness, and atherosclerotic burden: the link between macrocirculation and microcirculation.
abstract: The renal resistive index (RRI) measured by Doppler sonography is a marker of microvascular status that can be generalized to the whole of the arterial tree. Its association with large-vessel dysfunction, such as arterial stiffness or the atherosclerotic burden, can help to establish physiopathological associations between macrocirculation and microcirculation. The authors conducted a cross-sectional study of hypertensive patients (n=202) and a healthy control group (n=16). Stiffness parameters, atherosclerotic burden, and determination of the RRI in both kidneys were performed. The average RRI was 0.69±0.08 and was significantly greater in patients with diabetes and chronic kidney disease. Renal resistive index positively correlated with age, creatinine, and albuminuria. Positive correlations were found with arterial stiffness parameters (pulse wave velocity, ambulatory arterial stiffness index, and 24-hour pulse pressure), as well as atherosclerotic burden and endothelial dysfunction measured as asymmetric dimethylarginine in serum. In the multivariate analysis, independent factors for increased RRI were age, renal function, 24-hour diastolic blood pressure, and arterial stiffness. The authors concluded that there is an independent association between renal hemodynamics and arterial stiffness. This, together with the atherosclerotic burden and endothelial dysfunction, suggests that there is a physiopathologic relationship between macrovascular and microvascular impairment.
authors.affiliation: Department of Nephrology, University Hospital Dr. Josep Trueta, University of Girona, Girona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Calabia
authors.forename: Pere
authors.initials: P
authors.lastname: Torguet
authors.forename: Isabel
authors.initials: I
authors.lastname: Garcia
authors.forename: Nadia
authors.initials: N
authors.lastname: Martin
authors.forename: Gerard
authors.initials: G
authors.lastname: Mate
authors.forename: Adriana
authors.initials: A
authors.lastname: Marin
authors.forename: Carolina
authors.initials: C
authors.lastname: Molina
authors.forename: Marti
authors.initials: M
authors.lastname: Valles
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology / Q000503:physiopathology*; D001775:Blood Circulation / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D015994:Incidence; D007668:Kidney / Q000098:blood supply* / Q000502:physiology / Q000503:physiopathology; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000502:physiology* / Q000503:physiopathology; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance / Q000502:physiology*; D059289:Vascular Stiffness / Q000502:physiology*