Color Doppler sonographic appearance of renal perforating vessels in subjects with normal and impaired renal function.

Abstract

The purpose of this study was to assess the prevalence and color Doppler sonographic characteristics of perforating vessels-small arteries and veins connecting the intrarenal vasculature with the capsular plexus-in healthy subjects, in hypertensive patients, and in patients with renal failure due to hypertensive nephroangiosclerosis or ischemic nephropathy. Fifteen healthy subjects 24-34 years old, 15 healthy subjects 68-80 years old, 25 hypertensive patients, 25 patients with hypertension and chronic renal failure (15 mild, 10 severe), and 12 patients with hypertension and chronic renal failure and acute renal insufficiency due to ischemic nephropathy underwent color Doppler sonography of both kidneys. The few perforating arteries in healthy and hypertensive patients had various resistance indices and flow toward the capsule. Perforating veins in these patients were much more common than perforating arteries. Perforating arteries with a lower mean resistance index than the mean interlobar resistance index and flow toward the capsule were detected in 76% of kidneys in the patients with mild chronic renal failure and in 20% of those in patients with severe chronic renal failure. Only a few perforating veins were seen in patients with chronic renal failure. In 64% of the kidneys with renal artery stenosis detected in the patients with chronic renal failure complicated by acute renal insufficiency, there were perforating arteries with flow toward the kidney and a mean resistance index higher than the mean interlobar resistance index. Perforating vessels are recognizable using color Doppler sonography both in healthy subjects and in patients with renal failure. The prevalence and flow characteristics of perforating vessels differ between healthy subjects, patients with mild and with severe chronic renal failure, and patients with chronic renal failure complicated by acute renal insufficiency caused by renal artery stenosis.