Characteristic features of intrarenal blood flow in patients with essential hypertension and preclinical hypertensive nephropathy

Early stage of kidney damage in arterial hypertension (Ah) remains poorly understood. Criteria for the early stages of hypertensive nephropathy are not clearly defined, the clinical value of diagnostic and monitoring methods is not properly assessed. The aim of this study was to develop criteria for preclinical diagnosis of hypertensive nephropathy based on examination of renal hemodynamics. Material and methods: The study included 148 patients with stage II hypertension without clinically significant nephropathy. Results: Patients with stage II hypertension were found to have reduced intrarenal blood flow characterized by a decrease in Vmax and Vmin with a concomitant increase of renal resistance indices. Hyperfiltration phase in patients with hypertension was characterized by a relative increase in hemodynamic indices at the level of renal artery trunk and segmental artery, with a decline in the small arteries to the level of healthy people parameters. Hypofiltration was associated with marked increase of vascular resistance indices of the entire renal vascular bed, accompanied by microcirculatory disturbances and aggravation of glomerular ischemia. Renal hemodynamics assessment in patients with hypertension and high levels of albuminuria showed decrease in Vmin and the increase in IR.

hypertension, nephropathy, renal vascular Doppler sonography