The kidneys are thought to contribute to the pathogenesis of primary hypertension, but hypertension is also known to cause target organ damage in the kidney. Noninvasive methods to capture possible changes in the kidney related to hypertension are limited. A new program that has been used to quantify the heterogeneity and percent echogenicity in renal ultrasound images was implemented to assess patients with hypertension. Children and adolescents <21 years with primary hypertension diagnosed by ambulatory blood pressure monitoring were compared with normotensive age- and sex-matched controls. Renal ultrasound images were evaluated by a technique that measured pixels of gray-scale images and transformed them into a binary map, which was converted to a heterogeneity index (HI) and percent echogenicity score. This study included 99 children with hypertension and 99 control subjects. Body mass index (BMI) was greater in the hypertension group. Average HI for hypertension was significantly higher than in controls (1.37 ± 0.19 vs. 1.2 ± 0.23, P = .001), while echogenicity scores were not different (26.6 ± 8.9 vs. 25.9 ± 10, P = .8). In regression analysis adjusting for BMI z-score and race, hypertension was associated with greater HI compared with controls (β = 0.11, 95% confidence interval 0.03–0.18, P = .005). In a model adjusted for age, sex, and BMI z-score in the hypertension group only, no ambulatory blood pressure monitoring measures were associated with HI or echogenicity scores (P > .05).HI was significantly greater in the hypertension group compared with normotensive controls. HI may be a novel method to detect changes in the kidney related to hypertension.

人们认为肾脏有助于原发性高血压的发病，但是众所周知，高血压会导致肾脏靶器官损伤。捕获与高血压相关的肾脏可能变化的非侵入性方法受到限制。实施了一个新程序，用于量化肾脏超声图像中的异质性和回声百分率，以评估高血压患者。将通过动态血压监测诊断为患有21岁以下原发性高血压的儿童和青少年与血压正常的年龄和性别相匹配的对照组进行比较。通过测量灰度图像像素并将其转换为二进制图的技术对肾脏超声图像进行评估，然后将其转换为异质性指数（HI）和回声率百分比。这项研究包括99名高血压儿童和99名对照受试者。高血压组的体重指数（BMI）较高。高血压的平均HI显着高于对照组（1.37±0.19 vs. 1.2±0.23，P  = .001），而回声性评分没有差异（26.6±8.9与25.9±10，P  = .8）。在调整BMI z得分和种族的回归分析中，与对照组相比，高血压与较高的HI相关（β= 0.11，95％置信区间0.03–0.18，P  = .005）。仅在针对年龄，性别和BMI z得分进行了调整的模型中，高血压组没有动态血压监测措施与HI或回声评分相关（P  > .05）。高血压组的HI明显高于高血压组。血压正常控制。HI可能是检测与高血压有关的肾脏变化的新颖方法。