title: Intrarenal Vascular Resistance is Associated With a Prothrombotic State in Hypertensive Patients.
abstract: OBJECTIVE
  Hypertensive nephroangiosclerosis is associated with progressive increase of intrarenal vascular resistance. In addition to blood pressure, other factors can contribute to hypertensive renal damage including a prothrombotic state. We investigated the relationship between hemostatic markers and intrarenal vascular resistance in hypertension.
  
  
  METHODS
  In 115 untreated, nondiabetic, hypertensive subjects free of cardiovascular complications and advanced renal function impairment, we measured 24-hour creatinine clearance (GFR) and urinary albumin excretion (UAE), fasting plasma glucose, HOMA-index, and plasma levels of fibrinogen, D-dimer, prothrombin fragment 1+2, plasminogen activator inhibitor-1, homocysteine, and lipoprotein(a). In all patients, measurement of intrarenal resistance was obtained by renal Doppler ultrasound with calculation of the renal resistance index (RI).
  
  
  RESULTS
  Patients in the highest tertile of RI were older and had greater body mass index, pulse pressure, fibrinogen, and D-dimer levels and lower GFR than patients in the lowest RI tertile. RI was directly correlated with age, pulse pressure, HOMA-index, UAE, D-dimer, and inversely with GFR. On multivariate analysis, RRI was independently associated with age, GFR, and plasma D-dimer.
  
  
  CONCLUSIONS
  A prothrombotic state is associated with increased intrarenal vascular resistance in nondiabetic hypertensive patients and might contribute to the early stages of hypertensive renal disease.
authors.affiliation: Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Catena
authors.forename: GianLuca
authors.initials: G
authors.lastname: Colussi
authors.forename: Marileda
authors.initials: M
authors.lastname: Novello
authors.forename: Valentina
authors.initials: V
authors.lastname: Fagotto
authors.forename: Leonardo A
authors.initials: LA
authors.lastname: Sechi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019851:Thrombophilia / Q000097:blood / Q000503:physiopathology; D014655:Vascular Resistance / Q000502:physiology*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D