51 Stutzin, Godofredo, El Arrayán,
2.6 LA GESTION AMBIENTAL EMPRESARIAL Y SU RELACION CON LA RESPONSABILIDAD AMBIENTAL:
This study has shown that there is increase trend renal vascular impedance as demonstrated by the increasing renal resistive index (RI) in diabetic patients even without overt renal dysfunction. The association of RI with increasing glycaemic levels suggests that renal vascular impedance can be reduced with proper control of glycaemic levels, thus probably play a role in preventing progression to renal damage.
In this study, mean RI values of patients were not up to the levels suggested by Platt but an increasing trend was noted and further work may be necessary to establish a definite value for population as normal RI values may vary among operators or sonography machines. In conclusion, the present study demonstrates that duplex Doppler sonography may be a useful non-invasive tool in assessment of intrarenal hemodynamic abnormalities present in diabetic nephropathy
Over all, this study has suggested that Ultrasound can serve as a non-invasive, readily available and affordable modality for serial monitoring of renal vascular impedance during the course of management of diabetic nephropathy through the evaluation of RI.
76 6.2 RECOMMENDATIONS
1. A large longitudinal population-based study may be required before any clinically meaningful outcomes can be derived from our observations. This may suggest a different cut-off may be necessary to define what is considered high resistive index in our locality.
2. Therefore, in view of the above, larger multicentre studies may be necessary to define the pattern of resistive index among patients considered to have medical nephropathy
3. In addition, blood glucose levels should therefore be maintained as low as possible by lifestyle modification or pharmacological intervention to retard the development of atherosclerosis in diabetic patient.
77
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