INTRARENAL BLOOD FLOW DOPPLER SPECTRA IN DIABETIC PATIENTS AND HYPERTENSIVE DIABETIC PATIENTS: PP.17.146

Abstract

Objectives: The aim of the study was to determine the changes of Doppler spectra indices of intrarenal blood flow in diabetic patients with/without hypertension; to compare the changes of intrarenal vascular resistance in hypertensive diabetic patients with/without microalbuminuria. Methods: The 28 diabetic patients (Gr.D), 52 hypertensive patients (Gr.H), 208 diabetic hypertensive patients (Gr.HD) and 14 healthy people (control group). were included. The were no differences between the hypertensive groups in sex, age, BP-24 h levels and duration of arterial hypertension. Renal blood flow velocities profiles were detected by duplex scanning index in renal and arcuate intrarenal arteries; on the grounds of which resistive index in the segmental (RIs) and arcuate intrarenal arteries (RIar) was calculated. 24-hour ambulatory BP recordings were performed. Serum insulin concentration were measured by radioimmune method. 24-hour urinary protein excretion was determined by standart laboratory method. Results: 34,1% diabetic hypertensive patients, 13,3% hypertensive patients (P = 0,0005 vs Gr.HD) and 7,7% diabetic patients (P = 0,0245 vs Gr.HD) have microalbuminuria. Even normotensive diabetic patients show an increase in intrarenal vascular resistance: RIar levels were 0,63 ± 0,05 and 0,59 ± 0,04 in Gr.D vs 0,54 ± 0,06 and 0,48 ± 0,02 in the control group, respectively. Compared with pts of Gr.H, in pts of Gr.HD was observed more marked increase in intrarenal vascular resistance: RIar levels were 0,60 ± 0,05 in Gr.HD vs 0,57 ± 0,06 in Gr.H. In pts with microalbuminuria, the elevated indices of intrarenal vascular resistance were positively associated with duration of hypertension, age, levels of HbA1, triglycerides, total cholesterol and negatively associated with decrease in diastolic BP-day, diastolic BP-24 h and duration of diastolic arterial hypertension during daytime at disproportional increase in systolic BP. Conclusions: Our results show that the increase in intrarenal resistance is developed at earlier stages of diabetes. Hypertensive diabetic patients developed the increase in intrarenal resistance and/or microalbuminuria earlier as compared to hypertensive patients without diabetes.