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Nephrol Dial Transplant (1995) 10: 2060-2064
© 1995 European Renal Association-European Dialysis and Transplant Association


research-article

The pulsatility index and the resistive index in renal arteries in patients with hypertension and chronic renal failure

L. J. Petersen1,2,, J. R. Petersen2, S. D. Ladefoged1, J. Mehlsen2 and H. Æ. Jensen1

1Department of Nephrology, Hvidovre Hospital Hvidovre 2Department of Clinical Physiology and Nuclear Medicine, Frederiksberg Hospital Frederiksberg, Denmark

Correspondence and offprint requests to: Correspondence and offprint requests to: Lars Juhl Petersen MD, Department of Clinical Physiology & Nuclear Medicine, Frederiksberg Hospital, Ndr. Fasanvej 57, DK-2000 Frederiksberg, Denmark

BACKGROUND.: The pulsatility index (PI) and the resistive index (RI) are used as pulsed-wave Doppler measurement of downstream renal artery resistance. Little information is available on their value in chronic renal failure and their correlation to parameters of renal function and haemodynamics. The aim was to compare PI and RI of renal arteries in healthy volunteers and in patients with hypertension and chronic renal failure, and furthermore to study the correlation of these indices to measurements of renal haemodynamics and function by standard methods in patients with renal failure and hypertension.

METHODS.: Twenty-five hypertensive patients (10 females, 15 males, mean age 52 years (24–74) with a glomerular filtration rate (GFR) less than 50 ml/min and an arterial blood pressure above 140 mmHg systolic and 95 mmHg diastolic were included in the study. Ten healthy, normotensive volunteers (4 females and 6 males, mean age 43 years (30–62)) served as controls in the Doppler examinations. Doppler examinations were performed in segmental arteries by an Acuson 128. The PI and the RI was calculated from the blood flow velocities.

RESULTS.: Both the PI and the RI were significantly higher in the patient group (P) than in the control group (C) (PI, P 1.65 (1.31–1.86), C 1.19 (0.93–1.25), P=0.003; RI, P 0.76 (0.69–0.81), C 0.67 (0.64–0.70), P=0.003).

Both PI and RI correlated significantly with effective renal plasma flow (PI: r= –0.5, P=0.02; RI: r=–0.5, P=0.006), renal vascular resistance (PI: r=0.4, P= 0.05; RI: r=0.5, P=0.02), filtration fraction (PI: r=0.6, P=0.005; RI: r=0.5, P=0.01) and clearance of creatinine (PI: r=–0.6, P=0.008; RI: r=–;0.6, P= 0.006). Only RI correlated significantly to GFR (r=–0.5, P=0.02). The indices did not correlate to serum creatinine, or mean arterial blood pressure.

CONCLUSION.: PI and RI seems to be closely related to parameters of renal haemodynamics and clearance of creatinine in patients with chronic renal failure and hypertension.

Keywords: duplex scanning; Doppler measurements; renal artery; renal failure; renal function; renal haemodynamics


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