Institutional members access full text with Ovid®

Share this article on:

Structural alterations in subcutaneous small resistance arteries predict changes in the renal function of hypertensive patients

Boari, Gianluca EMa; Rizzoni, Damianoa; De Ciuceis, Carolinaa; Porteri, Enzoa; Avanzi, Danielea; Platto, Caterinaa; Mazza, Monicaa; Brignani, Alidab; Rosei, Claudia Agabitia; Ricotta, Dorisb; Caimi, Luigib; Rosei, Enrico Agabitia

doi: 10.1097/HJH.0b013e32833c2177
Original papers: Kidney

Background We have previously demonstrated that structural alterations in subcutaneous small resistance arteries of hypertensive patients, as indicated by an increased media to lumen ratio (M/L), are a potent predictor of cardiovascular events, and that a close correlation exists between serum creatinine and M/L. The aim of the present study was to assess whether M/L of subcutaneous small resistance arteries may predict subsequent changes in renal function in hypertensive patients.

Method Sixty participants (13 normotensive participants and 47 hypertensive patients) underwent a biopsy of subcutaneous fat. Resistance-sized arteries were dissected and mounted on a wire myograph, and M/L was measured. Patients were re-evaluated after a mean follow-up period of 8.6 years. Serum creatinine, blood urea nitrogen, and uric acid were measured; glomerular filtration rate (eGFR) was estimated according to Modification of Diet in Renal Disease formula.

Results At baseline, we observed significant correlations between M/L and serum creatinine, eGFR, blood urea nitrogen, systolic, diastolic, mean, and pulse pressure. In addition, we observed significant correlations between M/L and serum creatinine at follow-up (r = 0.57; P < 0.001), percentage changes in serum creatinine (r = 0.46; P < 0.001), eGFR at follow-up (r = −0.43; P < 0.001); percentage changes in eGFR, yearly changes in eGFR, blood urea nitrogen at follow-up, and uric acid at follow-up. A multivariate analysis in which all common cardiovascular risk factors were included showed that M/L ratio is the most potent predictor of changes in renal function.

Conclusion Our data suggest that structural alterations in subcutaneous small arteries may predict the time course of changes in renal function during a follow-up period of about 9 years.

aClinica Medica, Department of Medical and Surgical Sciences, University of Brescia, Italy

bChair of Clinical Biochemistry, Department of Biomedical Sciences and Biotechnology, University of Brescia, Brescia, Italy

Received 20 January, 2010

Revised 20 April, 2010

Accepted 12 May, 2010

Correspondence to Damiano Rizzoni, MD, Clinica Medica, Department of Medical and Surgical Sciences, University of Brescia, c/o 2a Medicina Spedali Civili di Brescia, Piazza Spedali Civili 1, 25100 Brescia, Italy Tel: +39 030 3995258; fax: +39 030 3384348; e-mail: rizzoni@med.unibs.it

© 2010 Lippincott Williams & Wilkins, Inc.