Characterization of Renal system Function and Morphology in Hypertensive Patients using Renal Scintigraphy and Ultrasonography

Abstract

The aim of this research to characterized the renal system function and morphology in adult hypertensive patients with further correlation to age, gender, body mass index, body surface area and duration of hypertension. A total of 75 patients (33 males, 42 females) with essential hypertension were evaluated sonographically in this prospective study and 25 healthy individuals (12 males, 13 females) were also evaluated as control groups. Renal volume was then calculated from the kidney's length, width and anterio-posterior diameter using formula (LxWxAPx0.53). The range of renal volume 46.65 to 105.02 cm3 for the left kidney and 42.59 to 102.33 cm3 for the right kidney. In control group, (mean ± SD) volumes of the right and left kidneys in males (80.7 cm3 ± 36 and 75.3 ±33respectively), in females (78.2 cm3 ± 33 and 70.4, ± 29 respectively). The (mean ± SD) kidney length was (9.95 ±2.3cm). It was (9.15 ±1.1cm) on the right side and (9.27 ±1.3 cm) on the left side. The hypertensive kidneys volume slightly in lower limit in compared to control group. The (mean ± SD) kidney width was (4.45 ±1.1cm) and the cortical thickness 1.46 ±0.5 cm, consider with in normal range. Renal volume correlated significantly with BMI in hypertensive patients (r= 0.35 and 0.31 p<0.005 for right and left kidney, respectively), There was no significant correlation between renal volume and duration of hypertension (r=0.9 and 0.8; p>0.005 for left and right kidneys, respectively). In radionuclide Renography, total glomerular filtration rate (GFR) ranged from 130-40 (mean ± SD) 87. 9±17.3 (male 86.8±16.3 female 88.8±18.1), correlated GFR with age decline rate was 0.82 (1.2 ml/min/years) Renal Scintigraphy demonstrated 84% has normal renal function with mild (AORTA- RENAL DELAY), normal cortical and clearance phase 16% had abnormal function (unilateral 93% and bilateral 7%. more affected RT kidney than left). Both kidneys show decrease renal function with age and duration of disease. The association was stronger in person had uncontrollable and long standing hypertensive disease. Also noted the average peak activity decrease when the duration of disease increase.