DOPPLER EVALUATION OF RENAL BLOOD FLOW AND CHANGES OF KIDNEY FUNCTION IN PATIENTS WITH ATHEROSCLEROTIC RENAL ARTERY DISEASE AFTER REVASCULARIZATION

THE AIM. To study the relationship between baseline Doppler parameters of arterial blood flow in the ischemic kidney and the functional state of organs after revascularization in patients with atherosclerotic renal artery disease (ARAD). PATIENTS AND METHODS. In 64 patients with haemodinamically significant ARAD (40 men and 24 women at the age of 47-78 years, average age 60±8 years) were analyzed the following parameters: blood flow peak systolic velocity, end-diastolic blood velocity (EDBV), pulse index (PI), resistive index (RI) and blood flow acceleration time (BAT) defined in renal artery (RA) and intraparenchymal arteries in 85 ischemic kidneys depending on renal function (RF) status after kidneys revascularization (KR). Also morphometric analysis of arterioles was performed. RESULTS. At patients with distant RF mend after its revascularization RI and PI were significantly lower in distal third of RA, segmental and interlobar arteries. The thickness of media and vascular index were significantly higher in ischemic kidneys of patients with distant GFR decline after KR. On the contrary, inner lumen of the arteries with external diameter>100 μm was less. The latter was directly related to the EDBV and back - with the RI in segmental arteries. CONCLUSION. Renoprotective effect of KR is detected by relative dynamics of GFR in pre- and postoperative periods, irrespective of blood pressure decreasing and is determined by intrarenal arterial bed status. After blood flow recovery in ischemic kidneys GFR can be increased at decreased intrarenal peripheral resistance which appears by saved EDBV and also low values of PI and RI at Doppler examination.

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