Renal Resistive Index from Renal Hemodynamics to Cardiovascular Risk: Diagnostic, Prognostic, and Therapeutic Implications

TY - JOUR

T1 - Renal Resistive Index from Renal Hemodynamics to Cardiovascular Risk

T2 - Diagnostic, Prognostic, and Therapeutic Implications

AU - Geraci, Giulio

AU - Ferrara, Pietro

AU - La Via, Luigi

AU - Sorce, Alessandra

AU - Calabrese, Vincenzo

AU - Cuttone, Giuseppe

AU - Paternò, Valentina

AU - Pallotti, Francesco

AU - Sambataro, Gianluca

AU - Zanoli, Luca

AU - George, Jacob

AU - Polosa, Riccardo

AU - Mulè, Giuseppe

AU - Carollo, Caterina

N1 - Publisher Copyright: © 2025 by the authors.

PY - 2025/6/9

Y1 - 2025/6/9

N2 - Duplex-Doppler ultrasonography has become an essential tool in the diagnosis and management of kidney diseases, allowing clinicians to assess renal hemodynamics, detect vascular abnormalities, and monitor disease progression. Among the various Doppler-derived parameters, the renal resistive index (RRI) has gained particular attention both as a diagnostic tool and a prognostic marker in nephrology. Traditionally considered an indicator of parenchymal perfusion, recent evidence highlights its strong association with systemic hemodynamic factors, particularly arterial stiffness, positioning RRI as a valuable tool for evaluating patients with systemic vascular impairment, such as hypertension, diabetes mellitus, and atherosclerosis. RRI has been strongly linked to vascular damage, which in turn is influenced by inflammation and endothelial dysfunction, making it a reliable marker of cardiovascular damage and a potential predictor of cardiovascular risk. Furthermore, emerging studies suggest that RRI could serve as a dynamic parameter to monitor vascular changes induced by therapeutic interventions. This narrative review summarizes the classic and evolving applications of RRI, from its origin as a renal hemodynamic marker to its emerging role as a systemic vascular biomarker with diagnostic and prognostic significance in cardiovascular and metabolic diseases.

AB - Duplex-Doppler ultrasonography has become an essential tool in the diagnosis and management of kidney diseases, allowing clinicians to assess renal hemodynamics, detect vascular abnormalities, and monitor disease progression. Among the various Doppler-derived parameters, the renal resistive index (RRI) has gained particular attention both as a diagnostic tool and a prognostic marker in nephrology. Traditionally considered an indicator of parenchymal perfusion, recent evidence highlights its strong association with systemic hemodynamic factors, particularly arterial stiffness, positioning RRI as a valuable tool for evaluating patients with systemic vascular impairment, such as hypertension, diabetes mellitus, and atherosclerosis. RRI has been strongly linked to vascular damage, which in turn is influenced by inflammation and endothelial dysfunction, making it a reliable marker of cardiovascular damage and a potential predictor of cardiovascular risk. Furthermore, emerging studies suggest that RRI could serve as a dynamic parameter to monitor vascular changes induced by therapeutic interventions. This narrative review summarizes the classic and evolving applications of RRI, from its origin as a renal hemodynamic marker to its emerging role as a systemic vascular biomarker with diagnostic and prognostic significance in cardiovascular and metabolic diseases.

KW - arterial stiffness

KW - cardiovascular risk

KW - Doppler ultrasonography

KW - hypertension

KW - renal hemodynamic

KW - renal resistive index

UR - https://www.scopus.com/pages/publications/105009309398

U2 - 10.3390/diseases13060178

DO - 10.3390/diseases13060178

M3 - Review article

C2 - 40558590

AN - SCOPUS:105009309398

SN - 2079-9721

VL - 13

JO - Diseases

JF - Diseases

IS - 6

M1 - 178

ER -