Pulsating Renal Blood Flow Distribution Measured Using Power Doppler Ultrasound: Correlation with Hypertension.

Arterial compliance is associated with the first stage of hypertension and atherosclerosis. We propose here a compliance index, which measures pulsating renal blood flow distribution using a power Doppler ultrasound (US). We assessed the relationship between the compliance index and blood pressure and between the compliance index and risk factors of atherosclerosis. The subjects consisted of 136 consecutive patients (96 males, 40 females) who underwent a physical checkup. Ages ranged from 40 to 60 years with a mean of 50.1 years. Patients with past renal disease and/or renal dysfunction were excluded. Using a power Doppler US combined with an ECG-gated and echo-tracking system, we recorded the vascular distribution of the renal parenchyma at 8 to 10 time points during an interval of the R wave of the ECG. Using a color pixel counting technique, we calculated the area (A) corresponding to the colored vascular distribution at power Doppler US. The relationships between A and the time points (t) were fitted to a quadratic equation. The compliance index of renal parenchymal vessels was obtained by twice differentiating the quadratic equation obtained above (d2A/dt2), and taking the result as a new hemodynamic index. In the univariate correlation analysis, the compliance index was correlated with age (r=-0.26, p=0.002), systolic blood pressure (r=-0.33, p=0.0001), diastolic blood pressure (r=-0.45, p<0.0001), serum uric acid (r=-0.28, p=0.001), and body mass index (r=-0.32, p=0.0002). On the multivariate stepwise regression analysis, the compliance index was significantly correlated with diastolic blood pressure (beta=-0.36, p<0.0001) and body mass index (beta=-0.18, p<0.0001). In conclusion, the compliance index is a candidate for a new hemodynamic marker of renal blood flow abnormality caused by hypertension.