RÉSUMÉ
Background: Renal resistive index (RRI) measured by Doppler ultrasonography has been associated with severity, rate of progression and mortality in chronic renal failure. Parameters like renal vascular resistance, filtration fraction and effective renal plasma flow have been associated with renal resistivity index in chronic kidney disease patients.Methods: This hospital based cross-sectional study was conducted from April 2016 to August 2017. 100 patients with chronic kidney disease were enrolled. RRI was calculated from the blood flow velocities observed during Doppler examinations of the segmental arteries and estimated glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Spearman Rank-Order Correlation Coefficient was used.Results: A Significant inverse correlation was observed between RRI and eGFR (r= -0.347, p =0.0004). It was also observed that older age (r= 0.297), higher systolic blood pressure (r= 0.365), lower levels of hemoglobin (r= -0.34 for males and r= -0.353 for females) were observed to correlate with higher values of RRI in advanced CKD stages.Conclusions: RRI correlated inversely with eGFR in chronic kidney disease and hence was directly related to the severity of the disease.
RÉSUMÉ
Introduction: Studies of renal perfusion when kidney function tests are still normal could be useful in understanding the pathophysiology of functional kidney impairment in cirrhosis. Kidney functional failure in cirrhosis is considered as a consequence of active renal vasoconstriction. The same have been studied by invasive and non-invasive methods. The present study is aimed at non-invasive assessment of renal artery resistance in patients of cirrhosis of liver. Materials and methods: The present study included 30 cases, patients with different stages of cirrhosis, who were clinically stable, while those with major complications like hepatic encephalopathy, major bleeding etc were excluded. All patients were evaluated clinically and a series of laboratory investigations were done. The resistance in the renal artery was calculates as Resistivity index, by using a color Doppler ultrasonography. Results: In our study, we found the main resistivity index was higher in cases with MELD >20. There was further increase in resistivity index as a severity of the cirrhosis increases. Similarly the MDRD EGFR was decreasing as the severity of cirrhosis was increased. Conclusion: Within limitations of the present study, we conclude that the estimation of the resistivity index in the kidney appears to be a sensitive and easy method for studying the early renal hemodynamic alterations in cirrhotic patients and thus by better understanding the Pathophysiology of hepatorenal syndrome.