Examination of Intrarenal Resistance Indices Indicate the Involvement of Renal Pathology as a Significant Diagnostic Classifier of Preeclampsia
| Autor: | Nielab Bahser, Cornelia Blume, Erhard Godehardt, Alexandra P. Hess |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Mean arterial pressure Cephalometry Kidney Severity of Illness Index Renal Circulation Preeclampsia Nephropathy Renal Artery Pre-Eclampsia Predictive Value of Tests Pregnancy Internal medicine medicine.artery Internal Medicine medicine Birth Weight Humans Proteinuria Cesarean Section business.industry Infant Newborn Ultrasonography Doppler Umbilical artery Prognosis medicine.disease Surgery Mean blood pressure Blood pressure Case-Control Studies Cardiology Female Vascular Resistance medicine.symptom business Head Live Birth Postpartum period |
| Zdroj: | American Journal of Hypertension. 27:742-749 |
| ISSN: | 1941-7225 0895-7061 |
| DOI: | 10.1093/ajh/hpt233 |
| Popis: | BACKGROUND Preeclampsia (PE) is a hypertensive disorder during pregnancy with endotheliosis leading to occlusion of renal perfusion with an impact on the glomerular filtration barrier. We therefore analyzed the role of intrarenal resistance indices in the renal interlobular arteries measured by Doppler ultrasound as a diagnosis of PE. METHODS Women with preeclampsia (n = 24; mean blood pressure/24 h = 145 ± 11/ 93 ± 7 mm Hg; mean proteinuria = 5.63 ± 1.0 g/24 h) were compared against a group of healthy pregnant women (n = 24). All patients underwent a Doppler ultrasound of the intrarenal arteries between the 24th week of gestation and the 5th week postpartum. Several risk factors for PE, as well as the arterial resistive indices of the Arteriae uterinae and the Arteria umbilicalis, were monitored in parallel. RESULTS The intrarenal resistive index (mean ± SD = 0.63 ± 0.05 in women with preeclampsia vs. 0.59 ± 0.056 in healthy pregnant women; P < 0.003), the pulsatile index (mean ± SD = 1.15 ± 0.19 in women with preeclampsia vs. 0.92 ± 0.13 in healthy pregnant women; P < 0.0001), and the end diastolic flow velocity (mean ± SD = 14.16 ± 4.75 cm/s in women with preeclampsia vs. 10.67 ± 2.68 cm/s in healthy pregnant women, P < 0.006) were elevated in patients with PE, as were the arterial resistive indices of the Aa. uterinae and A. umbilicalis. The intrarenal resistive indices correctly classified 84.2% of the women as having PE. CONCLUSIONS Intrarenal resistive indices are a significant classifier of PE, providing the possibility to predict nephropathy. They could be a prognostic tool for cardiovascular comorbidity in PE patients even after delivery. |
| Databáze: | OpenAIRE |
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