The role of ultrasound dopplerography with an acutecaptopril test in assessing renal hemodynamics in chronicglomerulonephritis

Abstract

Aim. To examine blood flow in renal and intrarenal arteries and its changes in the acute pharmacological
test with captopril in patients with chronic glomerulonephritis (CGN).
Material and methods. Renal circulation was studied in 50 patients with CGN using ultrasound dopplerography
(USDG) of renal vessels on the unit GE Logiq 400 CL PRO Series. The velocity and indices
of peripheral blood resistance in the major renal artery (RA) and in intrarenal arteries were estimated.
In 26 patients the blood flow was studied again after intake of 50 mg captopril.
Results. Poor renal blood flow was registered in cortical parenchyma in 36% CGN patients (with
chronic renal failure in 75%). Multifactorial regression analysis has demonstrated that only blood creatinine
was independently related with slowing down of the blood flow at the level of RA and intrarenal
arteries. Morphological index of activity correlated with resistance indices while a high sclerosis
index correlated with blood flow slowing. Older patients had higher resistance indices. Captopril significantly
accelerated Mod flow and insignificantly changed indices of peripheral resistance including
those in CRF patients.
Conclusion. Poor blood flow in the cortical layer of renal parenchyma in CGN, according to USDG,
occurs rather frequently and was associated with CRF and older age of the patients. Blocking of reninangiotensin
system at the level of angiotensin II formation improves renal blood flow in most of the patients.

References

  1. Mackenzie H. S., Brenner В. М. Current strategies for retarding progression of renal disease. Am. J. Kidney Dis. 1998; 31: 161-170.
  2. Тареева И. Е., Кутырина И. М., Николаев А. Ю. и др. Пути торможения развития хронической почечной недостаточности. Тер. арх. 2000; 6: 9-14.
  3. Wolf G. Angiotensin II: a pivotal factor in the progression of renal diseases. Nephrol. Dial. Transplant. 1999; 14 (suppl. 1): 42-44.
  4. Distler A., Spies K.-S. Diagnostic procedure in renovascular hypertension. Clin. Nephrol. 1991; 36: 174-180.
  5. Burdick L., Arioldi F., Marana I. et al. Superiority of acceleration time over pulsatility and resistance indices as screening tests for renal artery stenosis. J. Hypertens. 1996; 14:1229- 1235.
  6. Johansson M., Jensen G., Aurell M. et al. Evaluation of duplex ultrasound and captopril renography for detection of renovascular hypertension. Kidney Int. 2000; 58: 774-782.
  7. Radermacher J., Brunkhorst R. Diagnosis and treatment of renovascular stenosis - a cost - benefit analysis. Nephrol. Dial. Transplant. 1998; 13:2761-2767.
  8. Coen G., Manni M., Giannoni M. F. Ischemic nephropathy in an elderly nephrologic and hypertensive population. Am. J. Nephrol. 1998; 18: 221-227.
  9. Rene P. C., Oliva V. L., Bui В. Т. Renal artery stenosis: evaluation of Doppler US after inhibition of angiotensin-converting enzyme with captopril. Radiology 1995; 196: 675-679.
  10. Ходарева Е. Н., Сергиенко И. В. Значение радионуклидных методов исследования у больных реноваскулярной гипертонией. Визуализ. в клинике 1998; 6: 39-47.
  11. Djerassi R., Bogov В., Ljubomirova M. et al. What's new in the diagnostic algorithm in patients with chronic renal failure (CRF): conventional ultrasound Doppler wave analysis. In: Abstracts. XXXVI Congress of the ERA-EDTA. Madrid. 1999. 153.
  12. Petrichko M., Glazun L., Polukhina E. et al. Doppler evaluation of chronic renal failure progression in patients with chronic glomerulonephritis. Nephrol. Dial. Transplant. 2002; 17 (abstr. suppl. 1): 233-234.
  13. Matsumoto N., lshimura E., Taniwaki H. et al. Intrarenal hemodynamic abnormalities in no-dialyzed patients with chronic renal failure (CRF) measured by duplex Doppler sonography. In: Abstracts. XXXVI Congress of the ERA-EDTA. 1999. 173.
  14. Petersen L. J., Petersen J. R., Talleruthuus U. et al. The pulsatility index and the resistance index in renal arteries. Associations with long-term progression in chronic renal failure. Nephrol. Dial. Transplant. 1997; 12: 1376-1380.
  15. Бугрова О. В., Кутырина И. М., Багирова В. В. и др. Влияние острой фармакологической блокады ренин-ангиотензиновой системы на внутрипочечную гемодинамику больных системной красной волчанкой и системной склеродермией. Тер. арх. 2001; 6: 20-25.
  16. Meyrier A., Hill G. S., Simon P. Ischemic renal diseases: New insights into old entities. Kidney Int. 1998; 54: 2-13.
  17. London G., Marchais S. J., Giterin A. P. et al Arterial structure and function in end-stage renal disease. Nephrol. Dial. Transplant. 2002; 17: 1713-1724.
  18. Luke R. G. Hypertensive nephrosclerosis: pathogenesis and prevalence. Essential hypertension is a important cause of endstage renal disease. Ibid. 1999; 14: 2271-2278.
  19. Klahr S. The role of nitric oxide in hypertension and renal disease progression. Ibid. 2001; 16 (suppl. 1): 60-62.
  20. Есаян А. М., Каюков И. Г., Титова В. А. Влияние ингибитора ангиотензинпревращающего фермента эналаприла на темпы прогрессирования хронической почечной недостаточности у больных с нарушениями функционального состояния почек различной степени. Тер. арх. 1995; 5: 57- 59.
  21. Кутырина И. М., Тареева И. Е., Герасименко О. И. и др. Использование ингибиторов ангиотензинпревращающего фермента при хронических диффузных заболеваниях почек. Там же. 6: 20-23.
  22. Швецов М. Ю. Блокаторы рецепторов ангиотензина II - первый опыт и перспективы применения в нефрологии. Там же. 2000; 6: 73-79.
  23. Кутырина И. М., Лифишц Н. Л., Рогов В. А и др. Применение ингибиторов ангиотензинпревращающего фермента при хронической почечной недостаточности. Там же. 2002; 6: 34-39.

Copyright (c) 2003 Marlynov S.A., Shvetsov M.Y., Kutyrina I.M., Miroshnichenko N.G., Kushnir V.V., Petrov S.V., Struchkova T.Y., Dzhanaliev B.R., Varshavsky V.A., Proskurneva E.P.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

© 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies