Application Value Of Renal Blood Flow Ultrasound In Predicting Early Renal Damage In Hypertension

Objective: Chronic kidney disease is a worldwide public health problem because of its increased prevalence,poor prognosis and high cost of treatment.The early stage of hypertensive kidney injury is one of the important causes of chronic kidney disease.This study mainly discusses that renal blood flow ultrasound evaluates the clinical value analysis of hypertensive early renal damage.Methods: From August 2019 to January 2020,40 patients with early renal damage were selected as observation group and 40 patients without renal damage were randomly collected as control group.Renal arteries of two group patients were detected to use color Doppler ultrasonography,and to measure the ratio of peak systolic velocity between master renal artery and abdominal aorta,and systolic peak blood flow velocity,end-diastolic blood velocity,acceleration time,resistance index of the master renal artery at the renal hilum.The end-diastolic blood velocity,maximum systolic blood flow velocity and resistance index of the renal sinus segment and the interlobar arteries on both sides of the cone.To construct the receiver operating characteristic curves that obtained area under the curve,and analysis of the clinical value of renal artery ultrasound in predicting early renal injury in hypertensive patients.Results: There was no significant difference in the ratio of RAR between renal impairment patients with early hypertension and those without early renal impairment(P>0.05).There was no significant difference in the acceleration time of the master renal artery(P>0.05),and no significant difference in the peak systolic velocity of the master renal artery,renal segment artery and interlobar artery(P>0.05).The end-diastolic blood flow velocity of master renal artery,segment renal artery and interlobar artery in the observation group was lower than that in the control group(P<0.05).The resistance index of master renal artery,segment renal artery and interlobar artery was higher than that in the control group(P<0.05).The area(AUC)below the ROC curve for predicting early renal injury sensitivity was 0.775 and 0.847,according to the end-diastolic blood velocity and resistance index of the main renal artery in hypertensive patients;The area(AUC)below the ROC curve for predicting the sensitivity of early renal injury was 0.741 and 0.853,respectively,according to the end-diastolic blood flow velocity and resistance index of the segment renal artery;The area(AUC)below the ROC curve to predict the sensitivity of early renal injury was 0.833 and 0.949,according to the end-diastolic blood flow velocity and resistance index of the interlobar artery in the patient.Conclusion: The renal blood flow velocity decreased,vascular resistance increased and compliance decreased in patients with early renal injury with hypertension.The end-diastolic blood flow velocity of master renal artery,segment renal artery and interlobar renal artery was of low clinical value in predicting early renal injury,while resistance index was of high clinical value in predicting early renal injury.Using color Doppler ultrasound to detect renal artery hemodynamics in patients with essential hypertension can not only provide a favorable basis for early diagnosis of renal injury,but also effectively evaluate the prognosis of patients,which is worthy of clinical attention.