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Renal resistive index correlates with peritubular capillary loss and arteriosclerosis in biopsy tissues from patients with chronic kidney disease

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Abstract

Background

The renal resistive index (RI) is a Doppler-derived measure that reportedly correlates with renal histological changes and renal disease severity and outcome. The aim of this study was to investigate the factors related to the RI elevation in chronic kidney disease (CKD).

Methods

Using Doppler ultrasonography, RIs were determined in 30 patients with CKD, after which they were correlated with interstitial fibrosis, arteriosclerosis, arteriolosclerosis and peritubular capillary (PTC) density. PTC-positive areas were determined based on CD34 immunostaining. Interstitial fibrosis was detected with Masson trichrome staining. All histological markers were assessed using quantitative and semi-quantitative analyses and evaluated statistically using Pearson correlation tests, unpaired t tests and stepwise multiple regression analysis.

Results

RI correlated positively with age (r = 0.603, p = 0.0004), systolic blood pressure (r = 0.775, p < 0.0001), diastolic blood pressure (r = 0.575, p = 0.001), interstitial fibrosis (r = 0.381, p = 0.038) and arteriosclerosis (r = 0.520, p = 0.003), and negatively with creatinine clearance (r = −0.471, p = 0.009) and CD34+ (PTC) areas (r = −0.437, p = 0.016). Patients with hypertension or diabetes mellitus showed higher RIs (p < 0.05) than those without the ailments. Multivariate analysis showed PTC and arteriosclerosis to be independent variables correlating with RI (r 2 = 0.321, p < 0.05).

Conclusions

To our knowledge, this is the first report of using RI measurements to evaluate peritubular capillary loss. Our findings indicate that increases in RI are associated with both arteriosclerosis and loss of PTCs.

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References

  1. Rifkin MD, Needleman L, Pasto ME, Kurtz AB, Foy PM, McGlynn E, et al. Evaluation of renal transplant rejection by duplex Doppler examination: value of the resistive index. AJR Am J Roentgenol. 1987;148:759–62.

    Article  CAS  PubMed  Google Scholar 

  2. Radermacher J, Mengel M, Ellis S, Stuht S, Hiss M, Schwarz A, et al. The renal arterial resistance index and renal allograft survival. N Engl J Med. 2003;349:115–24.

    Article  PubMed  Google Scholar 

  3. Terry JD, Rysavy JA, Frick MP. Intrarenal Doppler: characteristics of aging kidneys. J Ultrasound Med. 1992;11:647–51.

    CAS  PubMed  Google Scholar 

  4. Shimizu Y, Itoh T, Hougaku H, Nagai Y, Hashimoto H, Sakaguchi M, et al. Clinical usefulness of duplex ultrasonography for the assessment of renal arteriosclerosis in essential hypertensive patients. Hypertens Res. 2001;24:13–7.

    Article  CAS  PubMed  Google Scholar 

  5. Florczak E, Januszewicz M, Januszewicz A, Prejbisz A, Kaczmarska M, Michałowska I, et al. Relationship between renal resistive index and early target organ damage in patients with never-treated essential hypertension. Blood Press. 2009;18:55–61.

    Article  PubMed  Google Scholar 

  6. Soldo D, Brkljacic B, Bozikov V, Drinkovic I, Hauser M. Diabetic nephropathy. Comparison of conventional and duplex Doppler ultrasonographic findings. Acta Radiol. 1997;38:296–302.

    CAS  PubMed  Google Scholar 

  7. Ishimura E, Nishizawa Y, Kawagishi T, Okuno Y, Kogawa K, Fukumoto S, et al. Intrarenal hemodynamic abnormalities in diabetic nephropathy measured by duplex Doppler sonography. Kidney Int. 1997;51:1920–7.

    Article  CAS  PubMed  Google Scholar 

  8. Sugiura T, Wada A. Resistive index predicts renal prognosis in chronic kidney disease: results of a 4-year follow-up. Clin Exp Nephrol. 2011;15:114–20.

    Article  PubMed  Google Scholar 

  9. Bigé N, Lévy PP, Callard P, Faintuch JM, Chigot V, Jousselin V, et al. Renal arterial resistive index is associated with severe histological changes and poor renal outcome during chronic kidney disease. BMC Nephrol. 2012;13:139.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Rigler AA, Vizjak A, Ferluga D, Kandus A, Buturović-Ponikvar J. Ultrasonography parameters and histopathology findings in transplanted kidney. Transplant Proc. 2013;45:1630–4.

    Article  CAS  PubMed  Google Scholar 

  11. Sugiura T, Nakamori A, Wada A, Fukuhara Y. Evaluation of tubulointerstitial injury by Doppler ultrasonography in glomerular diseases. Clin Nephrol. 2004;61:119–26.

    Article  CAS  PubMed  Google Scholar 

  12. Platt JF, Rubin JM, Ellis JH. Lupus nephritis: predictive value of conventional and Doppler US and comparison with serologic and biopsy parameters. Radiology. 1997;203:82–6.

    Article  CAS  PubMed  Google Scholar 

  13. Ikee R, Kobayashi S, Hemmi N, Imakiire T, Kikuchi Y, Moriya H, et al. Correlation between the resistive index by Doppler ultrasound and kidney function and histology. Am J Kidney Dis. 2005;46:603–9.

    Article  PubMed  Google Scholar 

  14. Mostbeck GH, Kain R, Mallek R, Derfler K, Walter R, Havelec L, et al. Duplex Doppler sonography in renal parenchymal disease histopathologic correlation. J Ultrasound Med. 1991;10:189–94.

    CAS  PubMed  Google Scholar 

  15. Platt JF, Ellis JH, Rubin JM, DiPietro MA, Sedman AB. Intrarenal arterial Doppler sonography in patients with nonobstructive renal disease: correlation of resistive index with biopsy findings. AJR Am J Roentgenol. 1990;154:1223–7.

    Article  CAS  PubMed  Google Scholar 

  16. Nangaku M. Mechanisms of tubulointerstitial injury in the kidney: final common pathways to end-stage renal failure. Intern Med. 2004;43:9–17.

    Article  CAS  PubMed  Google Scholar 

  17. Choi YJ, Chakraborty S, Nguyen V, Nguyen C, Kim BK, Shim SI, et al. Peritubular capillary loss is associated with chronic tubulointerstitial injury in human kidney: altered expression of vascular endothelial growth factor. Hum Pathol. 2000;31:1491–7.

    Article  CAS  PubMed  Google Scholar 

  18. Kang D-H, Kanellis J, Hugo C, Truong L, Anderson S, Kerjaschki D, et al. Role of the microvascular endothelium in progressive renal disease. J Am Soc Nephrol. 2002;13:806–16.

    Article  PubMed  Google Scholar 

  19. Basile DP, Donohoe D, Roethe K, Osborn JL. Renal ischemic injury results in permanent damage to peritubular capillaries and influences long-term function. Am J Physiol Renal Physiol. 2001;281:F887–99.

    Article  CAS  PubMed  Google Scholar 

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The authors declare that there is no conflict of interest.

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Correspondence to Noriyo Kimura.

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Kimura, N., Kimura, H., Takahashi, N. et al. Renal resistive index correlates with peritubular capillary loss and arteriosclerosis in biopsy tissues from patients with chronic kidney disease. Clin Exp Nephrol 19, 1114–1119 (2015). https://doi.org/10.1007/s10157-015-1116-0

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  • DOI: https://doi.org/10.1007/s10157-015-1116-0

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