RENAL HEMODYNAMICS EVALUATION IN PATIENTS SUFFERING FROM RHEUMATOID ARTHRITIS WITH AND WITHOUT COMORBID HYPERTENSION
https://doi.org/10.25207/1608-6228-2018-25-1-88-93
Abstract
Aim. To study the features of renal arterial blood flow in patients suffering from rheumatoid arthritis, its interaction with visual markers of atherosclerosis in the presence of comorbid hypertension.
Materials and methods. 113 patients with rheumatoid arthritis (RA) were enrolled into this study. Depending on the comorbidity of hypertension the patients were divided into two groups: without (n=53) and with hypertension (n=60). The comparison group consisted of 41 patients with arterial hypertension without RA. Clinical characteristics and blood biochemistry of all the patients were measured. Renal arterial resistance index (RI), presence of atherosclerotic plaques (ASP) in the carotid arteries were assessed by ultrasound scan.
Results. In this investigation we report the correlation of the of renal resistive index (RI) and ultrasound signs of carotid atherosclerosis with hypertension in patients with RA. It was found out that there is the increase of RI in RA associated with the age of patients, the onset of the disease at a later age, the presence of atherosclerotic plaques in the carotid arteries and hypertension. In addition, patients with RA had a high frequency of bilateral RI increase by more than 0.7 (64%). Patients with bilateral high RI had a two-fold increase in the registration rate of atherosclerotic plaques in both group of patients with RA.
Conclusion. Increased renal arteries RI in patients with RA is a factor associated with the comorbid hypertension and accompanied by more significant atherosclerotic changes in the carotid arteries in the form of an increased incidence of atherosclerotic plaques.
About the Authors
Zh. Z. OTAROVA
Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University of the Ministry of Healthcare of the Russian Federation.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
L. N. YELISEYEVA
Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University of the Ministry of Healthcare of the Russian Federation.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
O. I. ZHDAMAROVA
Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University of the Ministry of Healthcare of the Russian Federation.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
A. U. BLEDNOVA
Federal State Budgetary Educational Institution of Higher Education Kuban State Medical University of the Ministry of Healthcare of the Russian Federation.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
Russian Federation
Sedina str., 4, Krasnodar, 350063.
A. F. DAVYDOVA
Scientific Research Institution – S.V. Ochapovsky Regional Clinical Hospital № 1.
Russian Federation
Russian Federation
1 Maya str., 167, Krasnodar, 350086.
References
1. Клиппел Дж.Л., Стоун Дж.Х., Насонова Е.Л. Ревматические заболевания. Том 2. Заболевания костей и суставов. Москва: ГЭОТАР-Медиа; 2012. 134 с. [Klippel Dzh.L., Stoun Dzh.H., Nasonova E.L. Revmaticheskie zabolevanija. Tom 2. Zabolevanija kostej i sustavov. Moskva: GJeOTAR-Media; 2012. 134 s.].
2. Gabriel S.E., Michaud K. Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res. Ther. 2009; 11(3): 229-235. DOI: 10.1186/ ar2669.
3. Hodkinson B., Tikly M., Adebajo A. Rheumatoid arthritis in the developing world: stepping up to the challenge. Clin. Rheumatol. 2014; 33(9): 1195-1196. DOI: 10.1007/s10067-014-2690-3.
4. Dougados M., Soubrier M., Antunez A. et al. Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann. Rheum. Dis. 2014; 73(1): 62-68. DOI: 10.1136/ annrheumdis-2013-204223.
5. Peters M.J., Symmons D.P., Carey D.Mc et al. EULAR evidence-based recommendations for cardiovascular risk management in patients with rheumatoid arthritis and other forms of inflammatory arthritis. Ann Rheum Dis. 2010; 69(2): 325-31. DOI:10.1136/ard.2009.113696.
6. Sattar N., McCarey D.W., Capell H. et al. Explaining how «high-grade» systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation. 2003; 108: 2957-63. DOI: 10.1161/01.CIR.0000099844.31524.05.
7. Van Halm V.P., Nielen M.M., Nurmohamed M.T. et al. Lipids and inflammation: serial measurements of the lipid profile of blood donors who later developed rheumatoid arthritis. Ann Rheum Dis. 2007; 66:184-8. DOI: 10.1136/ard.2006.051672.
8. Tublin M.E., Bude R.O., Platt J.F. The resistive index in renal doppler sonography: where do we stand? Am J Roentgenol. 2003; 180(4): 885-892. DOI: 10.2214/ajr.180.4.1800885.
9. Kimura N., Kimura H., Takahashi N. et al. Renal resistive index correlates with peritubular capillary loss and arteriosclerosis in biopsy tissues from patients with chronic kidney disease. Clin Exp Nephrol. 2015; 19(6): 1114-1119.
10. Geraci G., Mulè G., Mogavero M. et al. Renal haemodynamics and severity of carotid atherosclerosis in hypertensive patients with and without impaired renal function. Nutr Metab Cardiovasc Dis. 2015; 25(2): 160-166. DOI: 10.1016/j. numecd.2014.10.008.
11. Елисеева Л.Н., Ждамарова О.И. Допплерографические показатели артериального и венозного кровотока в почках при гипертонической болезни. Российские Медицинские Вести. 2013; 18(3): 63-69. [Eliseeva L.N., Zhdamarova O.I. Dopplerograficheskie pokazateli arterial'nogo i venoznogo krovotoka v pochkah pri gipertonicheskoj bolezni. Rossijskie Medicinskie Vesti. 2013; 18(3): 63-69 (In Russ.)].
12. Taori K.B., Chaudhary R.S., Attarde V. et al. Renal Doppler indices in sickle cell disease: early radiologic predictors of renovascular changes. AJR Am J Roentgenol. 2008; 191(1): 239-42. DOI: 10.2214/ajr.07.3125.
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For citations:
OTAROVA Zh.Z., YELISEYEVA L.N., ZHDAMAROVA O.I., BLEDNOVA A.U., DAVYDOVA A.F. RENAL HEMODYNAMICS EVALUATION IN PATIENTS SUFFERING FROM RHEUMATOID ARTHRITIS WITH AND WITHOUT COMORBID HYPERTENSION. Kuban Scientific Medical Bulletin. 2018;25(1):88-93. (In Russ.) https://doi.org/10.25207/1608-6228-2018-25-1-88-93
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