Naslov
The Impact of Blood Pressure on Renal Resistance Index in Hypertensive Type 2 Diabetic Patients

Autori
LJUBIĆ, Spomenka ; BRKLJAČIĆ, Boris ; METELKO, Željko ; PAVLIĆ-RENAR, Ivana ; BOŽEK, Tomislav

Izvornik
Diabetologia. Supplement (Berlin) (0941-5602) 46 (2003);

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, kongresno priopcenje, znanstveni

Ključne riječi
hypertension; type 2 diabetes; renal resistance

Sažetak
Background and Aims: Changes in the vascular compartment in diabetic nephropathy result in the elevation of Doppler sonographic renal resistance index (RI). The aim of this study was to investigate the influence of blood pressure (BP) compared to other factors on RI changes. Materials and Methods: Fifty-four type 2 diabetic patients with arterial hypertension (25 male and 29 female ; age-range: 49&#61617; 5.84 years ; diabetes duration: 12&#61617; 5.44 years) were studied. Twenty-nine patients were treated with ACE-inhibitor (group A) and 25 with ACE-inhibitor/Ca2+ antagonist combination (group B). Patients were followed during a 2-year period. RI was determined at the beginning and at the end of the study. At the beginning of the study, stepwise regression method was used to analyze the influence of predictor variables: patient&#8217; s age, diabetes duration, systolic (SBP) and diastolic blood pressure, albumin excretion rate (AER), Tamm-Horsfall protein excretion rate (THPER), lipid values, glycated hemoglobin, serum creatinine and creatinine clearance on the elevation of the resistance index. Results: Stepwise regression method showed that SBP, disease duration and AER together explained nearly 54% of RI variance. SBP explained almost 22%, disease duration nearly 24% and AER nearly 7.5% of RI variance. At the end of the study a significant reduction in BP was found (p=0.0001), but it was not accompanied by RI reduction. Significant RI elevation was found in group A (p=0.006) and in the group of patients with diabetes duration &#8805; 10 years (p=0.001). Group A consisted of significantly more (19 of 27) patients with diabetes duration &#8805; 10 years compared to the group B (10 of 22). Significant differences in predictive variables between group A and group B were not found. Significant difference was found between the groups of patients with diabetes duration <10 years and &#8805; 10 years for SBP (p=0.033), AER (p=0.009), THPER (p=0.003), creatinine (p=0.005), creatinine clearance (p=0.001) and RI (p=0.002). Conclusions: Although BP was found to be an important variable in the prediction of RI, reduction of BP at the end of the study was not accompanied by RI reduction. Diabetes duration seems to be an important variable in RI elevation. RI could be considered as an indicator of microangiopathy changes in type 2 diabetic patients

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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