Intrarenal blood flow Doppler spectra in diabetes mellitus type 2

Objective. The study addresses the changes of Doppler spectra indices of intrarenal blood flow in diabetic patients with/without hypertension and the changes of intrarenal vascular resistance in hypertensive diabetic patients with/without microalbuminuria. Design and methods. 28 diabetic patients (Gr.D), 52 hypertensive patients (Gr.H), 208 diabetic hypertensive patients (Gr.HD) and 14 healthy people were included. Renal blood flow velocity profiles were detected by duplex scanning index in renal and arcuate intrarenal arteries and resistive index was calculated. 24-hour ambulatory blood pressure (BP) recordings were performed. Plasma glucose levels and serum insulin concentration were measured by radioimmune method. 24-hour urinary protein excretion was determined by standard laboratory method. Results. 34,1 % diabetic hypertensive patients, 13,3 % hypertensive patients (р = 0,0005) and 7,7 % diabetic patients (р = 0,0245) have microalbuminuria. Even normotensive diabetic patients show and increase in intrarenal vascular resistance. Patients in Gr.HD developed the increase in intrarenal vascular resistance and/or microalbuminuria earlier as compared to Gr.H. The elevated indices of intrarenal vascular resistance correlated positively with and hypertension duration of age, levels of HbA₁, triglycerides, total cholesterol and negatively with decrease in diastolic BP-day, diastolic BP-24h and duration of diastolic arterial hypertension during daytime at disproportional increase in systolic BP in patients having microalbuminuria.

hypertension, diabetes mellitus, duplex Doppler ultrasonography, intrarenal vascular resistance, microalbuminuria

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