The resistive index is a marker of renal function, pathology, prognosis, and responsiveness to steroid therapy in chronic kidney disease patients.
The resistive index is a marker of renal function, pathology, prognosis, and responsiveness to steroid therapy in chronic kidney disease patients.
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DOI：
10.1155/2012/139565
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发表时间：
2012
影响因子：
2.1
通讯作者：
Fujita T
中科院分区：
文献类型：
--
作者：
Hanamura K;Tojo A;Kinugasa S;Asaba K;Fujita T
为了评估肾阻力指数（RI）作为肾脏组织损伤的无创标志和预后指标的意义，我们对202例接受肾活检的慢性肾病（CKD）患者进行了多普勒超声检查。随着CKD分期的进展，RI增加，并与年龄、收缩压、估计肾小球滤过率（eGFR）和肾组织学改变（包括肾小球硬化、小动脉硬化和小管间质损伤）相关。中位随访38.5个月的预后评估显示，RI≥0.7（高RI组，n = 39）患者的肾生存期明显低于RI < 0.65（正常RI组，n = 120）和0.65≤RI < 0.7（高正常RI组，n = 43）的患者。高正常RI组患者对类固醇反应良好。然而，在高RI组中，类固醇治疗并没有显著改善肾脏生存。在研究的临床指标中，RI≥0.7、高血压、蛋白尿、诊断时eGFR偏低是肾功能恶化的独立危险因素。总之，慢性肾病患者的RI被认为是肾功能、组织学损害和肾脏预后的标志，可能是类固醇适应症的决定因素。
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.