Effects of Hypertension, Diabetes Mellitus, Obesity and Other Factors on Kidney Haemodynamics

Introduction: Kidney flow assessment and its haemodynamic surrogates, namely resistive index and renal flow reserve, may improve our understanding of the natural history of kidney dysfunction. Methods: We reviewed the literature on the common and differential effects of traditional risk factors such as essential hypertension, diabetes mellitus, dyslipidaemia, smoking, obesity and metabolic syndrome on human kidney haemodynamics. Results and conclusions: Aging, duration of a prevalent single cardiovascular risk factor and co-existence of multiple risk factors may further accelerate the deterioration of kidney haemodynamics. Sympathetic and renin-angiotensin-aldosterone axis activation is implicated in the pathophysiology leading to kidney function decline. Prevention of kidney disease progression includes the blockade of the renin-angiotensin-aldosterone axis, lipid lowering drugs, smoking cessation and glycaemic control as well as novel interventional methods like transluminal kidney sympathetic denervation.