| Preserved oxygenation despite reduced blood flow in poststenotic kidneys in human atherosclerotic renal artery stenosis. | |
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MedLine Citation:
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PMID: 20194303 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-03-01 |
Journal Detail:
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Title: Hypertension Volume: 55 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-18 Completed Date: 2010-04-09 Revised Date: 2011-07-27 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 961-6 Citation Subset: IM |
Affiliation:
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Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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P01 HL085307-020004/HL/NHLBI NIH HHS; P01HL085307/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
| Comments/Corrections | |
Comment In:
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Hypertension. 2010 Apr;55(4):838-9
[PMID:
20194299
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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