Document Detail


Preserved oxygenation despite reduced blood flow in poststenotic kidneys in human atherosclerotic renal artery stenosis.
MedLine Citation:
PMID:  20194303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atherosclerotic renal artery stenosis reduces blood flow and perfusion pressures to the poststenotic kidney producing renovascular hypertension and threatening glomerular filtration rate. Little is known regarding regional tissue oxygenation in human renovascular disease that develops slowly. We compared stenotic and contralateral kidneys regarding volume, tissue perfusion, blood flow measured by multidetector computed tomography, and blood oxygen level-dependent magnetic resonance values in the cortex and medulla in 14 patients with unilateral stenosis (mean: 71% by quantitative computed tomography) and in 14 essential hypertensive patients during 150 mEq/d of sodium intake and renin-angiotensin blockade. Stenotic kidney volume was reduced compared with the contralateral kidney (118.6+/-9.9 versus 155.4+/-13.7 mL; P<0.01), as was total blood flow (269.7+/-42.2 versus 383.7+/-49; P=0.02), mainly because of reduced cortical volume. Tissue perfusion was similar but lower than essential hypertension (1.5 versus 1.2 mL/min per milliliter; P<0.05). Blood oxygen level-dependent MR at 3 T confirmed elevated R2* values (a measure of deoxyhemoglobin) in deep medullary regions in all 3 sets of kidneys (38.9+/-0.7 versus cortex 17.8+/-0.36 s(-1); P<0.0001). Despite reduced blood flow, R2* values did not differ between atherosclerotic and essential hypertensive kidneys, although furosemide-suppressible fall in medullary R2* was reduced in stenotic kidneys (5.7+/-1.8 versus 9.4+/-1.9 s(-1); P<0.05). Renal venous oxygen levels from the stenotic kidney were higher than those from essential hypertensives (65.1+/-2.2 versus 58.1+/-1.2; P=0.006). These data indicate that, although stenosis reduced blood flow and volume, cortical and medullary oxygenation was preserved under these conditions.
Authors:
Monika L Gloviczki; James F Glockner; Lilach O Lerman; Michael A McKusick; Sanjay Misra; Joseph P Grande; Stephen C Textor
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-03-01
Journal Detail:
Title:  Hypertension     Volume:  55     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-18     Completed Date:  2010-04-09     Revised Date:  2011-07-27    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  961-6     Citation Subset:  IM    
Affiliation:
Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Atherosclerosis / pathology,  physiopathology*
Female
Glomerular Filtration Rate / physiology
Humans
Image Enhancement
Image Processing, Computer-Assisted
Ischemia / pathology,  physiopathology*
Kidney / blood supply,  pathology,  physiopathology*
Magnetic Resonance Imaging
Male
Middle Aged
Organ Size
Oxygen / blood*
Oxygen Consumption / physiology
Renal Artery Obstruction / pathology,  physiopathology*
Renal Circulation / physiology*
Grant Support
ID/Acronym/Agency:
P01 HL085307-020004/HL/NHLBI NIH HHS; P01HL085307/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
Hypertension. 2010 Apr;55(4):838-9   [PMID:  20194299 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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