Color Doppler ultrasonography for the assessment of renal blood flow in heart failure.

Abstract

To validate color Doppler ultrasonography of renal arteries for the assessment of renal blood flow (RBF), we compared left and right RBF estimates and their sum (total RBF) by echo-Doppler with data obtained by iodine 123-123I-p-aminohippuric acid (PAH) scintigraphy in 19 patients with heart failure and 7 normal control subjects. Single-side and total RBF estimates by echo-Doppler ranged, respectively, between 179 and 428 mL/min/m2 and from 378 to 835 mL/min/m2 in patients with heart failure and between 265 and 601 mL/min/m2 and from 564 to 1,182 mL/min/m2 in normal control subjects. Single-side and total RBF estimates by echo-Doppler correlated well with measurements obtained by scintigraphy (r = 0.74 and 0.76, respectively, in patients with heart failure; both: p < 0.001). At Bland and Altman's analysis of correspondence between the 2 techniques, there were 17 disagreements (33.7%) for single-side RBF and 8 disagreements (31.8%) for total RBF. However, the two techniques disagreed markedly in only two single-side and one total RBF estimates. Thus, in patients with heart failure, RBF assessed noninvasively by color Doppler ultrasonography has a good correlation with 123I-PAH renal scintigraphy data over a wide range of blood flow.