Renal duplex parameters, blood pressure, and renal function in elderly people
Renal duplex parameters, blood pressure, and renal function in elderly people
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DOI：
10.1053/j.ajkd.2005.01.028
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发表时间：
2005-05-01
影响因子：
13.2
通讯作者：
Hansen, KJ
中科院分区：
文献类型：
--
作者：
Pearce, JD;Edwards, MS;Hansen, KJ
背景。肾动脉和肾实质灌注的改变被认为与高血压的严重程度和肾功能恶化有关，但这些相关性的基于人群的研究尚不存在。本研究在以人群为基础的美国老年人队列中研究了肾双工超声（RDS）、血压（BP）和排泄肾功能参数之间的关系。方法：通过心血管健康研究的辅助研究，758名参与者（37%为男性，平均年龄77岁）接受了RDS，其中流速和频移是通过对从肾动脉和实质获得的多普勒位移信号的频谱分析确定的。这些双参数与血压和血清反相肌酐的关系通过多变量回归技术进行检验。结果：肾主动脉收缩期峰值血流速度（PSV）与血压呈独立相关性，PSV的SD升高（0.53 m/s）与收缩压（SBP）升高3.3 mm Hg和舒张压（DBP）降低2.4 mm Hg相关。舒张末期频移（EDF; 131 kHz）的SD降低与收缩压升高6.0 mm Hg、舒张压降低4.2 mm Hg和血清肌酐逆值显著降低3.7%相关。结论：肾动脉PSV升高和实质EDF降低与收缩压升高和舒张压降低有关。此外，实质EDF减少与排泄肾功能受损有显著关联。这些结果表明，肾双相参数与老年人高血压和进行性肾功能障碍引起的肾实质改变有关。
Background. Changes in renal artery and renal parenchyma perfusion are believed to correlate with severity of hypertension and worsened renal function, but population-based studies of these associations are not available. This study examines relationships between parameters derived from renal duplex sonography (RDS), blood pressure (BP), and excretory renal function in a population-based cohort of elderly Americans. Methods: Through an ancillary study to the Cardiovascular Health Study, 758 participants (37% men; mean age, 77 years) underwent RDS in which flow velocities and frequency shifts were determined from spectral analysis of Doppler-shifted signals obtained from the renal artery and parenchyma. Associations of these duplex parameters with BP and inverse serum creatinine were examined by using multivarlate regression techniques. Results: Main renal artery peak systolic flow velocity (PSV) showed independent associations with BP, with an SD increase in PSV (0.53 m/s) associated with a 3.3-mm Hg increase in systolic BP (SBP) and a 2.4-mm Hg decrease in diastolic BP (DBP). An SD decrease In end-diastolic frequency shift (EDF; 131 kHz) was associated with a 6.0-mm Hg increase in SBP, a 4.2-mm Hg decrease in DBP, and a significant 3.7% decrease in inverse serum creatinine. Conclusion: Increases in renal artery PSV and decreases in parenchymal EDF are associated with increased SBP and decreased DBP. Moreover, decreased parenchymal EDF showed significant associations with impaired excretory renal function. These results suggest that renal duplex parameters are associated with renal parenchymal changes caused by hypertension and progressive renal dysfunction in elderly people.