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RENAL ULTRASOUND FINDINGS IN ELDERLY PATIENTS WITH HIGH BLOOD PRESSURE: PP.30.205

Objective: Because in the elderly the clinical manifestations of chronic kidney disease (CKD) are atypical, the patient's pathology is complex and the investigations are limited (intravenous urography can not be made in all elderly), the renal ultrasound exam is the simplest investigation for elderly patients. In the majority of our patients, the diagnosis of a chronic pielonephritis is possible without other investigations that are more risky and expensive. The aim of this study is to establish the relationship between hypertension and the renal ultrasound exam. Design and Methods: The study was carried out on a group of 543 elderly hypertensive patients admitted, in a 3 years period, in the IVth Medical Clinic of the University of Medicine and Pharmacy “Victor Babes” Timisoara. The mean age of the patients was 78,5 ± 13,5 years. Of them 278 were women and 265 men. We performed in all patients a guided anamnesis, a complete clinical exam, and standard biological and imaging tests. We performed in all patients a renal ultrasound exam using an Aloka ProSound 4400 ultrasound system with a 3, 5 MHz transceiver. Results: In 52,1% of patients the right kidney had less then 10 cm, and in 53,03% of patients the left kidney was smaller then 10 cm. The exterior contour of the right kidney was unequal in 50,6% of patients and of the left kidney in 51,7% of patients. The parenchyma index was less then 1,5 in the right kidney of 52,3% patients and in the left kidney of 51,7% patients. The ultrasound exam was normal according to the age of the patients in 53,2% of all patients. One patient had polycystic kidney disease and 2 patients had just one kidney. Conclusions: Renal ultrasound exam is an important way to diagnose secondary hypertension. In elderly CKD is very common.