The internist and the renal resistive index: truths and doubts

Internal and Emergency Medicine
Maria BoddiElisa Ciani

Abstract

The renal resistive index (RRI) is measured by Doppler sonography in an intrarenal artery, and is the difference between the peak systolic and end-diastolic blood velocities divided by the peak systolic velocity. The RRI is used for the study of vascular and renal parenchymal renal abnormalities, but growing evidence indicates that it is also a dynamic marker of systemic vascular properties. Renal vascular resistance is only one of several renal (vascular compliance, interstitial and venous pressure), and extrarenal (heart rate, aortic stiffness, pulse pressure) determinants that combine to determine the RRI values, and not the most important one. RRI cannot always be considered a specific marker of renal disease. To summarize from the literature: (1) hydronephrosis, abdominal hypertension, renal vein thrombosis and acute kidney injury are all associated with an acute increase in interstitial and venous pressure that determine RRI values. In all these conditions, RRI is a reliable marker of the severity of renal damage. (2) The hemodynamic impact of renal artery stenosis can be assayed by the RRI decrease in the homolateral kidney by virtue of decreasing pulse pressure. However, renal diseases that often coexist, increase renal...Continue Reading

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Citations

Sep 26, 2015·Internal and Emergency Medicine·Giuseppe MulèSantina Cottone
Aug 18, 2016·Clinical and Experimental Nephrology·Pierpaolo Di Nicolò, Antonio Granata
Sep 7, 2016·Diabetes & Metabolic Syndrome·Baris Afsar, Rengin Elsurer
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Apr 3, 2020·The Journal of Rheumatology·Antonietta GiganteMarco Matucci-Cerinic
Nov 11, 2021·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Luigi PetramalaClaudio Letizia

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