The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients
To evaluate the significance of the renal resistive index (RI) as a noninvasive marker of renal histological damage and a prognostic indicator, we examined RI by Doppler ultrasonography in 202 chronic kidney disease (CKD) patients who underwent renal biopsy. RI increased as the CKD stage progressed...
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Wiley
2012-01-01
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Series: | International Journal of Nephrology |
Online Access: | http://dx.doi.org/10.1155/2012/139565 |
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author | Kikuno Hanamura Akihiro Tojo Satoshi Kinugasa Kensuke Asaba Toshiro Fujita |
author_facet | Kikuno Hanamura Akihiro Tojo Satoshi Kinugasa Kensuke Asaba Toshiro Fujita |
author_sort | Kikuno Hanamura |
collection | DOAJ |
description | To evaluate the significance of the renal resistive index (RI) as a noninvasive marker of renal histological damage and a prognostic indicator, we examined RI by Doppler ultrasonography in 202 chronic kidney disease (CKD) patients who underwent renal biopsy. RI increased as the CKD stage progressed and correlated with age, systolic blood pressure, estimated glomerular filtration rate (eGFR), and renal histological changes, including glomerulosclerosis, arteriolosclerosis, and tubulointerstitial damage. Prognostic evaluation with a median follow-up period of 38.5 months revealed that patients with RI≥0.7 (high RI group, n=39) had significantly poorer renal survival than those with RI<0.65 (normal RI group, n=120) and 0.65≤RI<0.7 (high-normal RI group, n=43). The patients in the high-normal RI group showed good response to steroids. However, in the high RI group, steroid therapy did not significantly improve renal survival. Of the clinical indices studied, RI≥0.7, hypertension, proteinuria, and low eGFR at diagnosis were independent risk factors for worsening renal dysfunction. In conclusion, RI in CKD patients was considered as a marker of renal function, histological damage, and renal prognosis, and a possible determinant of indication for steroids. |
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id | doaj-art-676d1d3478d24c79b90e8eba62e45a2d |
institution | Kabale University |
issn | 2090-214X 2090-2158 |
language | English |
publishDate | 2012-01-01 |
publisher | Wiley |
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series | International Journal of Nephrology |
spelling | doaj-art-676d1d3478d24c79b90e8eba62e45a2d2025-02-03T06:06:23ZengWileyInternational Journal of Nephrology2090-214X2090-21582012-01-01201210.1155/2012/139565139565The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease PatientsKikuno Hanamura0Akihiro Tojo1Satoshi Kinugasa2Kensuke Asaba3Toshiro Fujita4Division of Nephrology and Endocrinology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDivision of Nephrology and Endocrinology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDivision of Nephrology and Endocrinology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDivision of Nephrology and Endocrinology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDivision of Nephrology and Endocrinology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanTo evaluate the significance of the renal resistive index (RI) as a noninvasive marker of renal histological damage and a prognostic indicator, we examined RI by Doppler ultrasonography in 202 chronic kidney disease (CKD) patients who underwent renal biopsy. RI increased as the CKD stage progressed and correlated with age, systolic blood pressure, estimated glomerular filtration rate (eGFR), and renal histological changes, including glomerulosclerosis, arteriolosclerosis, and tubulointerstitial damage. Prognostic evaluation with a median follow-up period of 38.5 months revealed that patients with RI≥0.7 (high RI group, n=39) had significantly poorer renal survival than those with RI<0.65 (normal RI group, n=120) and 0.65≤RI<0.7 (high-normal RI group, n=43). The patients in the high-normal RI group showed good response to steroids. However, in the high RI group, steroid therapy did not significantly improve renal survival. Of the clinical indices studied, RI≥0.7, hypertension, proteinuria, and low eGFR at diagnosis were independent risk factors for worsening renal dysfunction. In conclusion, RI in CKD patients was considered as a marker of renal function, histological damage, and renal prognosis, and a possible determinant of indication for steroids.http://dx.doi.org/10.1155/2012/139565 |
spellingShingle | Kikuno Hanamura Akihiro Tojo Satoshi Kinugasa Kensuke Asaba Toshiro Fujita The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients International Journal of Nephrology |
title | The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients |
title_full | The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients |
title_fullStr | The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients |
title_full_unstemmed | The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients |
title_short | The Resistive Index Is a Marker of Renal Function, Pathology, Prognosis, and Responsiveness to Steroid Therapy in Chronic Kidney Disease Patients |
title_sort | resistive index is a marker of renal function pathology prognosis and responsiveness to steroid therapy in chronic kidney disease patients |
url | http://dx.doi.org/10.1155/2012/139565 |
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