OBJECTIVE: To non-invasively study the effects of continuous positive airway pressure breathing (CPAP) on renal vascular resistance in normal subjects and renal allograft recipients, in other words those with with denervated kidneys. We could then ascertain the influence of renal innervation on any resulting changes in renal haemodynamics. METHODS: Ten healthy volunteers and six renal transplant patients were studied. Using Doppler ultrasonography, the pulsatility index (PI), an index of renovascular resistance, was measured at incremental levels of CPAP (0, 2.5, 5.0 and 7.5 cmH2O). RESULTS: In both groups, the PI increased significantly between 0 and5.0 cmH2O CPAP, with a further increase at 7.5 cmH2O CPAP. CONCLUSIONS: We found that CPAP at 5.0 and 7.5 cmH2O caused a significant increase in renovascular resistance in both normal and renal transplant patients. There was no difference in the degree of rise in renovascular resistance between both groups, indicating that the renal nerves do not play a role in altering renal vascular resistance with the application of CPAP.

译文

目的: 非侵入性地研究持续气道正压呼吸 (CPAP) 对正常受试者和同种异体肾移植受者,即失神经肾受者的肾血管阻力的影响。然后,我们可以确定肾脏神经支配对肾脏血流动力学任何变化的影响。方法: 对10名健康志愿者和6名肾移植患者进行研究。使用多普勒超声检查,在CPAP (0、2.5、5.0和7.5 cmH2O) 的增量水平下测量搏动指数 (PI),即肾血管阻力指数。结果: 在两组中,PI在0至5.0 cmH2O CPAP之间显着增加,在7.5 cmH2O CPAP时进一步增加。结论: 我们发现5.0和7.5 cmH2O的CPAP导致正常和肾移植患者的肾血管阻力显着增加。两组之间的肾血管阻力上升程度没有差异,表明使用CPAP时,肾神经在改变肾血管阻力方面不起作用。

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