Интраренальная и центральная гемодинамики после травмы почки Grade I‑III: существует ли прямая причинно-следственная связь с посттравматической артериальной гипертензией?

Abstract

Introduction. Mechanical kidney injuries lead to renal dysfunction and vasospastic reaction, resulting in adaptive reactions of the organism, with the possibility of formation of secondary arterial hypertension. Purpose of the study: to determine the types of central gemodynamics, intrarenal blood flow characteristics, correlation interrelations of indices and to estimate the risks of secondary posttraumatic arterial hypertension development after Grade I-III kidney injury. Material and methods. Systemic hemodynamic parameters with identification of blood circulation type and intrarenal hemodynamic parameters were studied in 196 male victims in the posttraumatic period, the control group consisted of 30 men. During statistical processing Pearson correlation coefficients (r) and linear regression coefficient of determination (r2) were additionally calculated. Results. After kidney injury, the organ blood flow velocity was increased from 12,5% to 31,2%, resistance index (RI) increased from 4,7% to 44,8%, and pulsation index (PI) decreased from 9,2% to 41,2%. The indices of intrarenal vascular resistance were in negative from very strong to medium strength correlation with the parameters of systemic hemodynamics in the following gradation structure by decreasing strength: total peripheral resistance → diastolic blood pressure → systolic blood pressure → mean arterial pressure → stroke volume → cardiac index → minute volume of blood. Hypokinetic type steadily prevailed in central hemodynamics, the share of eukinetic type increased, and hyper-kinetic type of hemodynamics remained at a constant level. Conclusion. After kidney injury of non-critical severity the ascertained parameters of systemic and organ hemodynamics do not possess predictive power for realization of direct causal relationship in the development of secondary renoparenchymatous arterial hypertension.