Low systolic blood pressure values, renal resistive index measurement and glomerular filtration rate in a non-dialysis dependent chronic kidney disease population

  • Simone Brardi | sibrardi@gmail.com Hemodialysis Unit, S. Donato Hospital, Arezzo, Italy.
  • Gabriele Cevenini Department of Medical Biotechnologies, University of Siena, Italy.

Abstract

Objective: A longitudinal prospective case control study was organized to explore the relationships between glomerular filtration rate (GFR), renal resistive index (RRI) and blood pressure values in a non-dialysis dependent adult population affected by chronic kidney disease and exposed to low systolic blood pressure (SBP) values.
Material and methods: The study sample (54 patients: 31 males and 23 females with an average age of 61.7 ± 19.2 years) was randomly selected from a population of adult non-dialysis dependent patients that scored a SBP < 100 mmHg at the medical examination. The patients were equally divided in two groups defined by the presence and absence of chronic kidney disease, (i.e. a GFR less or greater than 60 ml/min/1.73 m2, respectively). Patients were submitted to a full therapeutic and dietetic intervention to correct the hypotension until reaching a steady SBP > 100 mmHg.
Results: In the group with chronic renal disease, the comparison between the data recorded with SBP < 100 mmHg (t0) and those detected with SBP ≥ 100 mmHg (t1) showed a statistically significant decrease of serum creatinine as well as an increase of GFR (mean serum creatinine t0 – serum creatinine t1: 0.194 ± 0.35, p < 0.01; mean GFR t0 – GFR t1: -4.615 ± 8.8, p < 0.013). There was also a statistically significant reduction of the RRI (mean right kidney RRI t0 – mean right kidney RRI t1: + 0.082 ± 0.03, p < 0; mean left kidney RRI t0 – mean left kidney RRI t1: 0.076 ± 0.03, p < 0).
Conclusion: We concluded that, in CKD, when aorta is stiffed, a decrease of SBP can limit the renal perfusion that, in this condition, is mostly dependent by stroke volume, causing an increase of RRI and a decrease of GFR that we suppose as reversible with the restoration of SBP.

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Published
2019-01-17
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Section
Original Papers - Stones and Infections
Keywords:
longitudinal prospective case control study, chronic kidney disease, renal Doppler ultrasonography, renal resistive index, low systolic blood pressure
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How to Cite
Brardi, S., & Cevenini, G. (2019). Low systolic blood pressure values, renal resistive index measurement and glomerular filtration rate in a non-dialysis dependent chronic kidney disease population. Archivio Italiano Di Urologia E Andrologia, 90(4), 288-292. https://doi.org/10.4081/aiua.2018.4.288