INTRARENAL VASCULARIZATION IN HYPERTENSIVE NEPHROSCLEROSIS. CORRELATION WITH ENDOTHELIAL FUNCTION

Objective: Renal involvement in essential hypertension, known as hypertensive nephrosclerosis represents an important cause of end-stage renal disease. But essential hypertension leads to cardiovascular morbidity and mortality, too. Endothelial dysfunction represents the first step in atherosclerosis development, and atherosclerotic cardiovascular disease. The aim of this study is represented by the assessment of intrarenal vascularization in hypertensive nephrosclerosis and correlations between it and endothelial function, glomerular filtration rate, albumin-to-creatinine ratio. Design and method: The study was performed on a group of 30 patients with essential hypertension. In all patients were determined: systolic blood pressure (SBP), diastolic blood pressure (DBP), glomerular filtration rate (GFR), albumin-to-creatinine ratio (ACR), resistive index (RI) of interlobar renal arteries. Endothelial function was assessed by means of flow mediated dilation (FMD) of brachial artery. All the data were presented as mean ± standard deviation. The statistically analysis was done using Pearson's test and Student's t-test, p < 0,05 was considered statistically significant. Results: The mean age of patients was 54,76 ± 7,67 years. The mean values of investigated parameters were: SBP 176 ± 17,09 mmHg, DBP 96,83 ± 6,76 mmHg, GFR 66 ± 14,70 ml/min, ACR 105,87 ± 65,63 mg/g, RI 0,72 ± 0,03, FMD 7,74 ± 2,64%. FMD was correlated with GFR (p < 0,001), ACR (p < 0,001), RI (p < 0,01), SBP (p < 0,01), DBP (p < 0,05). Significant positive correlations were identified between RI and ACR, respective SBP (p < 0,001), and significant negative correlations were identified between RI and GFR (p < 0,001), respective DBP (p < 0,05). Conclusions: In patients with hypertensive nephrosclerosis, impaired intrarenal vascularization is associated with endothelial dysfunction, reduced glomerular filtration rate and greater ACR.