Russian Heart Failure Journal 2007year Renal hemodynamics in patients with chronic heart failure


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2007/

Renal hemodynamics in patients with chronic heart failure

Reznik E.V., Gendlin G.E., Storozhakov G.I., Volynkina V.M.

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Urgency. Changes in renal blood flow play an important role in the pathogenesis of renal disorders in patients with CHF. However peculiarities of renal hemodynamics and their relation with common manifestations of renal dysfunction and severity of clinical symptoms in patients with CHF are insufficiently studied. Aim. Studying disorders of renal hemodynamics in patients with CHF; interrelation of altered renal hemodynamics with manifestations of disturbed functional state of kidneys; interrelation of changes in renal hemodynamics with severity of clinical symptoms in these patients. Materials and methods. Forty-eight patients with LV EF<40% were evaluated. Renal hemodynamics was examined by renal artery duplex scans (RADS). Functional state of kidneys was characterized using comprehensive biochemical tests. Urinary albumin excretion was measured in the morning portion of urine using enzyme-linked immunosorbent assay (ELISA) and in 24‑hour urine using turbidimetric immunoassay (TIA). Glomerular filtration rate was evaluated using the Cocroft-Gault formula and MDRD1. Results. Renal dysfunction with reduced glomerular filtration rate (GFR) and increased urinary albumin excretion was observed in almost 2/3 of evaluated patients with CHF. Changes in renal hemodynamics in patients with CHF included reduction of linear and volume blood flow rate and increased peripheral renal resistance index. The changes in renal hemodynamics correlated with urinary albumin excretion and reduced GFR, which allowed considering them as a sign of renal dysfunction in patients with CHF. Parameters of renal hemodynamics stronger correlated with severity of clinical condition than parameters of echoCG in these patients. Microalbuminuria and considerable changes in renal hemodynamics were observed more frequently in patie.

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