Key result
A prothrombotic state, indicated by elevated plasma D-dimer, was independently associated with increased intrarenal vascular resistance in untreated, nondiabetic hypertensive patients.
Observational (n=115)
A prothrombotic state, indicated by elevated D-dimer, is independently associated with increased intrarenal vascular resistance in early-stage hypertensive patients.
Supports prothrombotic-renal vascular link in early hypertension; leaves open whether D-dimer-guided therapy alters resistance.
BACKGROUND/AIMS: 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.
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Catena et al. (2016) conducted an observational in Hypertension (n=115). Prothrombotic state markers was evaluated on Association between hemostatic markers and intrarenal vascular resistance (RI). A prothrombotic state, indicated by elevated plasma D-dimer, was independently associated with increased intrarenal vascular resistance in untreated, nondiabetic hypertensive patients.
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