Renal Hemodynamics in Patients with End Stage Renal Disease / 中华高血压杂志

ABSTRACT

Objective To investigate the relationship between refractory hypertension and renal hemodynamics in end stage renal diseases (ESRD) patients.Methods ESRD patients were classified intopatients with refractory hypertension (group A) and patients with normal blood pressure(group B).Renal hemodynamic indices were ex- amined by duplex ultrasonography.Fasting serum lipid (TC,TG,HDL-C,LDL-C,Lp(a),ox-LDL) and serum parathyroid hormane (PTH) were determined in all patients.Results Significant differences were found in renal hemodynamic indices such as peak systolic velocity (PSV),mean flow velocity (MV),pulsatility index (PI),renal- aortic ratio (RAR) and in clinical index such as Lp(a) and ox-LDL between the two group.Refractory hyperten- sion patients had lower renal hemodynamic indices and higher Lp(a) and ox-LDL levels than in patients with con- trolled BP.Logistic regression analysis revealed that refractory hypertension was related with PSV,EDV,Pl and RAR,but not relevant with sex,age,dialysis time,hematocrit,BUN,creatinine,TC,TG,HDL-C,LDL-C, PTH,MV and RI.Conclusion Atherosclerotic renal artery stenosis and severe disorder in renal hemodynamics is likely the cause for refractory hypertention in ESRD patients.The rise of serum Lp(a) and ox-LDL might acceler- ate renal artery atherosclerosis.