Affiliation:
1. Service of Nephrology and Hypertension, Lausanne University Hospital and University of Lausanne , Lausanne , Switzerland
2. Service of Clinical Pharmacology, Lausanne University Hospital and University of Lausanne , Lausanne , Switzerland
Abstract
ABSTRACT
Background
Microvascular structural alteration and dysfunction is a hallmark of arterial hypertension. So far, the visualization and the quantification of renal microcirculation in humans has been hampered by the lack of non-nephrotoxic and non-invasive radiologic techniques. Contrast-enhanced ultrasonography (CEUS) is an appealing method to investigate renal microcirculation and has not been investigated in this setting. We aimed to compare renal microcirculation in normotensive (NT) and hypertensive (HT) participants using CEUS at rest and during a sympathetic stress test.
Methods
We measured the renal perfusion index (PI, primary outcome), the renal resistive index (RRI), beat-to-beat systemic hemodynamics and plasma catecholamines before and during a 2-min cold pressor test (CPT) in NT and HT participants. Linear mixed model analysis was used to compare the effect of the CPT on the variables of interest.
Results
Seventy-three participants (32 HT) with normal kidney function were included. HT participants had a lower baseline PI compared with NT participants [median (interquartile range) 1476 (959–2155) arbitrary units (a.u.) vs 2062 (1438–3318) a.u., P < .001]. The CPT increased blood pressure, heart rate and catecholamines in all participants. The increase in PI observed in NT during the CPT was blunted in HT [+504 (117–920) a.u. vs +1159 (678–2352) a.u in NT, interaction P = .013]. Age, sex and body mass index did not modify these results.
Conclusions
HT patients had a lower basal renal cortical perfusion. During the cold pressor test, HT participants had a smaller increase in the PI, suggesting that renal cortical flow reserve is impaired.
Funder
Swiss National Science Foundation
Swiss Heart Foundation
Publisher
Oxford University Press (OUP)
Subject
Transplantation,Nephrology
Cited by
1 articles.
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