Background/Aims: Hypertensive nephroangiosclerosis is associated with progressive increase
of intrarenal vascular resistance. In addition to blood pressure, other factors can contribute to
hypertensive renal damage including a prothrombotic state. We investigated the relationship
between hemostatic markers and intrarenal vascular resistance in hypertension. Methods:
In 115 untreated, nondiabetic, hypertensive subjects free of cardiovascular complications
and advanced renal function impairment, we measured 24-hour creatinine clearance (GFR)
and urinary albumin excretion (UAE), fasting plasma glucose, HOMA-index, and plasma
levels of fibrinogen, D-dimer, prothrombin fragment 1+2, plasminogen activator inhibitor-1,
homocysteine, and lipoprotein(a). In all patients, measurement of intrarenal resistance was
obtained by renal Doppler ultrasound with calculation of the renal resistance index (RI).
Results: Patients in the highest tertile of RI were older and had greater body mass index,
pulse pressure, fibrinogen, and D-dimer levels and lower GFR than patients in the lowest
RI tertile. RI was directly correlated with age, pulse pressure, HOMA-index, UAE, D-dimer,
and inversely with GFR. On multivariate analysis, RRI was independently associated with age,
GFR, and plasma D-dimer. Conclusions: A prothrombotic state is associated with increased
intrarenal vascular resistance in nondiabetic hypertensive patients and might contribute to the
early stages of hypertensive renal disease.
