michigan hypertension core curriculum - State of Michigan

Table 5. Clinical evaluation of renal parenchymal disease (nephropathy)
Factor Comment
Serum creatinine Easy to measure and inexpensive. Relatively
insensitive to degree of renal dysfunction (see Figure
7), and not reliable for differentiating nephropathy
from renal ischemia.
Proteinuria Easy to measure and inexpensive. Proteinuria ≥ 1
gram/24 hour is a good indication of nephropathy,
but lesser degrees of proteinuria are less reliable.
Renal dimensions Renal length 10 – 12 cm is generally favorable.
Renal resistive index
(RRI)
Renal length ≤ 6 cm indicates irreversible renal injury
(atrophic kidney).
RRI < 0.7 is a good measure of reversibility.
Although RRI > 0.8 indicates parenchymal disease,
it should not be used as the sole indicator of
irreversible renal dysfunction.
Renal arteriogram Preservation of cortical blood flow and absence
of intra-renal arteriolar disease are indicators of
reversible renal dysfunction. Poor cortical blood flow
and severe diffuse intra-renal arteriolar disease are
markers of advanced nephropathy (see Figure 5).
Renal Biopsy Reliable for histologic confirmation of nephropathy,
but not practical for most patients
NKFM & MDCH 129