Online ISSN 2313-1519
Print    ISSN 1812-2892
Abstract - Estimation of Renal Hemodynamics Before and After Administration of Nitrates in Patients with Chronic Kidney Disease
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Abduzhappar Gaipov, Nurlan Zhampeissov, Karlygash Kuzembayeva, Suindyk Imankulov, Aliya Dzholdasbekova, Saltanat Tuganbekova

The aim of the study: evaluation of renal hemodynamics in response to nitrate administration in patients with stages 0-3 chronic kidney disease (CKD) with the use of renal Doppler ultrasound.

Methods: This is a prospective cross-sectional study, included 52 patients (32 men and 20 women), mean age 43,0 ± 13,6 years. Of them, 12 healthy subjects assigned as group 0-CKD (glomerular filtration rate – GFR > 90 mL/min), 10 patients with stage 1 CKD (GFR > 90 mL/min), 15 patients with stage 2 CKD (GFR 89-60 mL/min) and 15 patients with stage 3 CKD (GFR 59-30 mL/min). All patients underwent renal artery Doppler ultrasound before and after administration of isosorbide dinitrate aerosol in dose of 1.25 mg sublingually.

Results:  A decrease of Vmax (peak systolic velocity) and Vmin (end diastolic velocity) in groups of patients with CKD-2 (p ≤ 0,006) and CKD-3 (p ≤ 0,002) observed at the interlobar and arcuate renal arteries after the introduction of isosorbide dinitrate. GFR was positively correlated with baseline Vmax (r = 0,346; p = 0,012) and Vmin (r = 0,406; p = 0,003) at the level of the segmental renal arteries. Nitrate administration increased the power of correlation (r = 0,407; p = 0,003 and r = 0,527; p < 0,0001, respectively) and provided close relation between GFR and velocity parameters at the level of interlobar (r = 0,315; p = 0,024 and r = 0,413; p = 0,003, respectively), and arcuate renal arteries (r = 0,331; p = 0,025 and r = 0,507; p < 0,0001, respectively).

Conclusion: Improvement in renal hemodynamics after nitrate administration was pronounced in patients with stage 2-3 CKD. Vmax and Vmin change in response to nitrate correlated with GFR. Among the possible reasons can be discussed depletion of endogenous nitric oxide in the early stages of CKD.

 

Volume 4, Number 30 (2013)