Renal resistive index as a marker of cardiac damages in patients with chronic kidney disease
Renal vascular resistance detected by ultrasound Doppler correlates with the severity of the renal disease and with the renal function. The aim of this study was to estimate the renal resistive index (RI) as a marker of cardiac damages in patients with chronic kidney disease (CKD). 128 patients (mean age 40,1 ± 0,96 years) with CKD 1-3 stages (by NKF K/DOQI classification, 2002) were included in the study. The glomerular filtration rate (GFR) was estimated by the serum creatinine level and age using the MDRD equation; left ventricular hypertrophy (LVH) was determined according to echocardiography criteria. We examined renal vascular resistance by Doppler ultrasonography in main, segmentar, interlobal and arcuate arteries of kidneys. We estimated the prevalence of arterial hypertension, left ventricular hypertrophy (LVH), stable angina pectoris and chronic heart failure (CHF) in 1-3 stages of CKD. Stepwise multiple regression analysis showed that only RI interlobal arteries (RI IA) can be chosen as an independent factor for development of LVH, stable angina and CHF. RI IA >0,64 showed the accuracy of 72,6%, sensitivity of 65,1% and specificity of 80,0% for LVH; the accuracy of 73,3%, sensitivity of 71,5% and specificity of 75,0% for stable angina; and the accuracy of 72,7%, sensitivity of 66,7% and specificity of 78,7% for CHF.