Related Experiment Videos
[Renal digital angiography in the study of hypertensive patients]
Insights
Renovascular hypertension (BH) suspicion is indicated by altered Renal Doppler Ultrasonography (RDA) findings, particularly in mild-moderate cases. Early BH evolution periods correlate with RDA alterations, suggesting its utility in diagnosis.
Area of Science:
- Nephrology
- Cardiology
- Radiology
Background:
- Blood hypertension (BH) affects numerous individuals, necessitating accurate etiological diagnosis.
- Identifying the cause of BH, especially renovascular causes, is crucial for effective management.
- Renal Doppler Ultrasonography (RDA) is a non-invasive imaging technique used in hypertension evaluation.
Purpose of the Study:
- To investigate the utility of Renal Doppler Ultrasonography (RDA) in diagnosing renovascular blood hypertension (BH).
- To determine the correlation between RDA findings and the characteristics of blood hypertension, including severity and evolution time.
- To compare the diagnostic value of RDA with intravenous urography for renovascular BH.
Main Methods:
- Fifty patients with blood hypertension (BH) underwent Renal Doppler Ultrasonography (RDA) as part of an etiological study.
- Evaluated variables included blood pressure levels, therapy index, BH evolution time, BH type (refractory, severe, mild-moderate), and organ damage.
- RDA alterations were analyzed in relation to different BH classifications and clinical parameters.
Main Results:
- RDA alterations were observed in 16 out of 50 patients.
- The prevalence of RDA alterations was higher in the mild-moderate BH group (58.3%) compared to severe (28.6%) and refractory (10%) BH groups.
- Patients with altered RDA had a significantly shorter BH evolution period (3.49 years) than those with normal RDA (6.93 years).
Conclusions:
- Renal Doppler Ultrasonography (RDA) alterations are a valuable indicator for suspecting renovascular blood hypertension (BH).
- The clinical suspicion, especially in mild-moderate BH cases, should guide the decision for renovascular exploration rather than solely relying on BH severity.
- RDA demonstrates comparable diagnostic utility to intravenous urography in the initial screening for renovascular BH.
Abstract:
50 patients, 31 male and 19 female with mean age of 45.1 +/- 9.4 years afflicted with blood hypertension (BH) were studied. RDA was performed on all of them as part of the etiological study. The variables evaluated were: systolic blood pressure (SBP), diastolic blood pressure (DBP), therapy index (TI), evolution time of its BH and type of BH (refractory BH, severe BH, mild-moderate BH). The organ affliction was also evaluated (renal function, ECG, presence of cardiomyopathy, vascular disease, and retinopathy. RDA alteration appeared in 16 cases, 1 (10%) in refractory BH group, 8 (28.6%) in severe BH group, and 7 (58.3%) in mild-moderate BH group. A shorter BH evolution period having been observed in patients with altered RDA than in those with normal RDA (3.49 +/- 3.96 years vs 6.93 +/- 4.68 years p = 0.01). We conclude that only this variable is a feature for suspicion of renovascular BH, without an apparent difference between the results of RDA and those of I.V. urography, obtained during the diagnosis screening. The significant differences observed between the mild-moderate BH and the other groups suggests that the clinical suspicion, and not the severity of the BH, is the point which should determine the patients to be renovascularly explored.