Renal arterial pulsatility predicts progression of chronic kidney disease in chronic heart failure patients.

Chronic kidney disease (CKD) is frequent in CHF patients, and is associated with adverse prognosis. The pathophysiology of kidney dysfunction in CHF patients is multifactorial and has not yet been clearly defined. In CKD it has recently been reported that the assessment of renal Doppler pulsatility index (PI), a Doppler derived index dependent on downstream renal artery resistance and stiffness, correlates with the degree of intrarenal damage and is a predictor of subsequent renal function. In order to investigate whether an increased PI may correlate with the progression of CKD in CHF, 68 consecutive patients underwent renal ultrasonography. The focal zone of the pulsed Doppler was positioned at the level of the right renal segmental arteries. We determined the peak systolic velocity (V max), the end-diastolic velocity (V min) and the mean velocity (V mean) in order to calculate the dimensionless PI value: (V max − V min) / V mean. Renal function was assessed at baseline and after 6 months of follow-up. Estimated glomerular filtration rate (eGFR) was calculated according to the CKD-EPI equation.