We hypothesize that in general the relative base flow is less or equal then 20%.
ID
Bron
Verkorte titel
Aandoening
Renal artery stenosis, renovascular disease, hypertension, chronic kidney disease
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Dynamic range of renal blood flow, represented by the relative baseline flow (RBF), the ratio between the difference of baseline and minimal flow velocity and baseline flow velocity.
Achtergrond van het onderzoek
In patients with atherosclerotic renal artery stenosis (RAS), combined intra-renal pressure and flow measurements allow a comprehensive evaluation of macro- and microvascular renal disease, which may help to identify patients who will benefit from percutaneous transluminal renal angioplasty (PTRA). Based on the findings of the first HERA study, intra-renal pressure and flow measurements are feasible, safe and reproducible. Before we study the clinical utility of pressure-and flow guided renal revascularization, we first need to determine the physiological range of pressure and flow variations in the renal artery. This can be performed by measuring exercise-induced minimal flow next to dopamine-induced hyperemia. In addition, the relation of pressure and flow may also help us to assess renal autoregulation which is important for the maintenance of renal perfusion in patients with renovascular disease and chronic kidney insufficiency. The primary objective of this study is to assess the dynamic range of renal pressure and flow velocity under exercise induced minimal flow and dopamine induced hyperemia. Secondary objectives are to assess intra-individual variations in the range of pressure and flow and to assess renal autoregulation.
Doel van het onderzoek
We hypothesize that in general the relative base flow is less or equal then 20%.
Onderzoeksopzet
-
Onderzoeksproduct en/of interventie
The study will compromise a series of intra-renal pressure and flow measurements that are consecutively performed at rest, during exercise induced minimal flow, and during hyperemia. The measurements will be performed following routine cardiac care or peripheral angiography/intervention by an experienced interventionalist. Minimal flow will be induced by a static and dynamic handgrip test. Hyperemia will be induced by a slow bolus injection of dopamine 30 μg·kg-1 injected directly into the renal artery.
Publiek
Wetenschappelijk
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
Age > 18
Written informed consent
Clinically and hemodynamically stable
Clinical indication for a coronary, renal, or peripheral vascular angiography with or without percutaneous intervention.
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
Recent ST-segment elevation myocardial infarction (<6 weeks prior to enrolment)
Known cardiac arrhythmias Known heart failure (NYHA class > II)
Increased risk for contrast nephropathy defined as presence of renal impairment (eGFR <30ml/min) according to the Guideline Safe Use of Contrast Media of the Radiology Society of the Netherlands (November 2017) Women of child bearing age not on active birth control
Inability to sign an informed consent, due to any mental condition that renders the subject unable to understand the nature, scope, and possible consequences of the trial or due to mental retardation or language barrier
Opzet
Deelname
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In overige registers
| Register | ID |
|---|---|
| NTR-new | NL7946 |
| Ander register | METC AMC : METC 2018_305 |