Increased renal resistive index (>0.72) was independently associated with the presence of albuminuria in patients with type 2 diabetes (95% CI 1.53-15.46; P<0.01).
Cross-Sectional (n=150)
Is renal vascular resistance associated with albuminuria and aorta stiffness in patients with type 2 diabetes?
In patients with type 2 diabetes, increased renal vascular resistance is independently associated with albuminuria and aortic stiffness, suggesting a role for ischemic nephropathy in diabetic renal damage.
p-value: p=<0.01
OBJECTIVE: Albuminuria can be caused by endothelial dysfunction as a result of ischemic nephropathy rather than classic diabetic nephropathy. We studied whether renal vascular resistance (resistive index RI) of the main renal arteries could be associated with albuminuria and further assessed the relationship between RI and aorta stiffness measured by brachial-ankle pulse-wave velocity (baPWV). RESEARCH DESIGN AND METHODS: We consecutively studied 150 patients with type 2 diabetes and the absence of clinically overt renal artery stenosis. Renal function expressed as the estimated glomerular filtration rate (eGFR) was calculated using the modified formula of modification of diet in renal disease (MDRD). The RI (peak systolic velocity -end-diastolic velocity)/peak systolic velocity was measured with duplex Doppler ultrasonography. RESULTS: When the presence of albuminuria (uAlb) was defined as urinary albumin-to-creatinine ratio (microg/mg x creatinine) >30, mean RI (left RI + right RI)/2 was significantly higher in uAlb, compared with that in patients without uAlb. RI had significant associations with age (r = 0.398, P 0.72 (median) was significantly associated with age (P < 0.01, 95%CI 1.02-1.19), diastolic blood pressure (P < 0.01, 0.86-0.97), and uAlb (P < 0.01, 1.53-15.46), respectively. Moreover, RI was an independent risk factor for uAlb after adjustment of both diastolic blood pressure and eGFR. CONCLUSIONS: Renal vascular resistance was associated with albuminuria and aorta stiffness. Increased RI may imply the presence of any type of underlying renal damage, including ischemic nephropathy.
Hamano et al. (2008) conducted a cross-sectional in Type 2 diabetes (n=150). Increased renal resistive index (RI >0.72) vs. RI ≤0.72 was evaluated on Presence of albuminuria (urinary albumin-to-creatinine ratio >30) (95% CI 1.53-15.46, p=<0.01). Increased renal resistive index (>0.72) was independently associated with the presence of albuminuria in patients with type 2 diabetes (95% CI 1.53-15.46; P<0.01).