Renal vascular resistance is increased in patients with kidney transplant

Päivärinta, Johanna; Oikonen, Vesa; Räisänen-Sokolowski, Anne; Tolvanen, Tuula; Löyttyniemi, Eliisa; Iida, Hidehiro; Nuutila, Pirjo; Metsärinne, Kaj; Koivuviita, Niina

doi:10.1186/s12882-019-1617-2

Cited by 9 publications

(12 citation statements)

References 52 publications

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“…AR is typically diagnosed by increased serum creatinine concentration (Scr), decreased glomerular filtration rate (GFR), changes in urine volume, and biopsy (19,20). Unfortunately, these indicators are delayed and insensitive biomarkers of AR (21)(22)(23)(24), usually reflecting a late sign of kidney damage. Therefore, the identification of more sensitive and specific biomarkers for the early diagnosis of acute renal rejection is imperative (19).…”

Section: Introductionmentioning

confidence: 99%

STXBP3 and GOT2 predict immunological activity in acute allograft rejection

Yao

Wang

et al. 2022

Front. Immunol.

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BackgroundAcute allograft rejection (AR) following renal transplantation contributes to chronic rejection and allograft dysfunction. The current diagnosis of AR remains dependent on renal allograft biopsy which cannot immediately detect renal allograft injury in the presence of AR. In this study, sensitive biomarkers for AR diagnosis were investigated and developed to protect renal function.MethodsWe analyzed pre- and postoperative data from five databases combined with our own data to identify the key differently expressed genes (DEGs). Furthermore, we performed a bioinformatics analysis to determine the immune characteristics of DEGs. The expression of key DEGs was further confirmed using the real-time quantitative PCR (RT-qPCR), enzyme-linked immunosorbent assay (ELISA), and immunohistochemical (IHC) staining in patients with AR. ROC curves analysis was used to estimate the performance of key DEGs in the early diagnosis of AR.ResultsWe identified glutamic-oxaloacetic transaminase 2 (GOT2) and syntaxin binding protein 3 (STXBP3) as key DEGs. The higher expression of STXBP3 and GOT2 in patients with AR was confirmed using RT-qPCR, ELISA, and IHC staining. ROC curve analysis also showed favorable values of STXBP3 and GOT2 for the diagnosis of early stage AR.ConclusionsSTXBP3 and GOT2 could reflect the immunological status of patients with AR and have strong potential for the diagnosis of early-stage AR.

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Section: Introductionmentioning

confidence: 99%

STXBP3 and GOT2 predict immunological activity in acute allograft rejection

Yao

Wang

et al. 2022

Front. Immunol.

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“…RI can also be reliably measured in renal grafts if accessible (25). Päivärinta et al assessed the kidney function with PET-CT and RI measurements with CCDS to show that the RI was correlated with perfusion and fibrosis of the transplants (26). Boran et al found an association between recipients with proteinuria <1,000 mg/24 h, and elevated RIs (27).…”

Section: Discussionmentioning

confidence: 99%

Association of Intrarenal Resistance Index and Systemic Atherosclerosis After Kidney Transplantation

Köger

Engelberger

Thalhammer

et al. 2021

In Vivo

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Background/Aim: Patients after kidney transplants are at risk of cardiovascular morbidity. An elevated resistance index (RI) is associated with renal graft failure, while a decreased RI can be due to a renal artery stenosis. The RI can also be measured in the carotid artery. Whether a correlation between intrarenal RI after kidney transplant in adult patients and the RI of the internal carotid artery exists is still unclear. Patients and Methods: In this prospective cross-sectional study, RI of kidney transplants and of the internal carotid artery were measured with duplex sonography. Carotid intima-media thickness as well as the Framingham risk score and the Augmentation index, all known markers of atherosclerosis, were assessed. Correlations between the RI in Carotid artery and the RI of the kidney transplant were based on Spearmen test with the level of significance set at p<0.05. Results: Ninety-eight consecutive patients [60% male, mean age of 48.7 (±15.6)] were included. The mean interval after transplantation was 27.5 (±8.5) months and mean serum creatinine was 308 (±220.3) mmol/ml The RI of the internal carotid artery and the renal transplant were significantly correlated (p<0.05). A correlation between the RIs and the Augmentation Index was found. Conclusion: The RI of the kidney transplant is correlated with the RI of the carotid artery and to markers of general atherosclerosis. This observation may be helpful to identify patients after kidney transplant with higher risk for cardiovascular events and gain indirect information on transplant renal artery stenosis.Kidney transplant is the most frequently performed organ transplant (1). Computed tomography (CT) and coronary Angio-CT are used for risk stratification in kidney transplant candidates for risk stratification before transplantation (2). It is the treatment of choice in end-stage renal disease (ESRD) and is ideally performed before initiation of hemodialysis (3). It is also more cost-effective than long-term dialysis (4). Color-coded Doppler sonography (CCDS) is part of the postoperative surveillance (5). The surveillance may start as early as during, but should be initiated immediately after transplant (6). Besides the diagnosis of arterial or venous obstruction, the intrarenal vascular resistance, called Resistance Index (RI) is measured (7). While the RI can be difficult to measure in orthotope kidneys it is often easier to assess in the more superficial transplant in the iliac fossa. Nonetheless, accessibility can be limited due to different factors such as pain, obesity, flatulence amongst others. The RI has been a proven to be sensitive marker of graft dysfunction, but is unspecific (8). The RI of the kidney transplant adapts rapidly to the host ( 9). An elevated RI of 0.80 (normal range=0.6-0.7) or higher indicates an unfavorable prognosis of renal function as well as increased mortality (10). A decreased RI can be a sign for a renal stenosis (11). RI measurement is observer dependent (12). There is a significant association between an incr...

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“…assessed the kidney function with PET-CT and RI measurements with CCDS to show that the RI was correlated with perfusion and brosis of the transplants [22]. Boran et al found an association between recipients with proteinuria < 1000 mg/24 h, and elevated RIs [23].…”

Section: Discussionmentioning

confidence: 99%

Association of Intrarenal Resistance Index and Systemic Atherosclerosis After Kidney Transplantation.

Köger

Engelberger²,

Wüthrich

et al. 2021

Preprint

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Background Patients after kidney transplant are at risk of cardiovascular morbidity. Surveillance of kidney transplants is mandatory to ensure a maximal transplant lifespan. Renal function is measured by levels of creatinine (clearance) while morphological aspects and other parameters like the kidney-size and Resistance Index are assessed with Duplex sonography. An elevated Resistance Index is associated with renal graft failure. The Resistance Index can also be measured in the carotid artery. It is uncertain whether a correlation between intrarenal RI after kidney transplant and the RI of the internal carotid artery exists. Material and Methods Resistance index of kidney transplants and of the carotid artery were measured with duplex sonography in adult patients after kidney transplant. Carotid intima-media thickness as well as the Framingham risk score and the Augmentation index, all known markers of atherosclerosis, were assessed. Statistical analysis was performed with STATA. Continuous data were expressed as means +/- standard deviation and compared by Kruskal-Wallis Test. Correlations between the RI in Carotid artery and the RI of the kidney transplant were based on Spearmen test with the level of significance set at p < 0.05. Results 98 consecutive patients (60% male, mean age of 48.7 (+/-15.6)) were included. Mean interval after transplantation was 27.5 (+/- 8.5) months and the mean serum creatinine was 308 (+/- 220.3) mmol/L. The RI of the internal carotid artery and the renal transplant were significantly correlated (p < 0.05). A strong correlation between the RIs and the Augmentation Index (AIx) was found. Conclusion The RI of the kidney transplant is correlated with the RI of the carotid artery and to markers of general atherosclerosis. This observation may be helpful to identify patients after kidney transplant with higher risk for cardiovascular events.

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Renal vascular resistance is increased in patients with kidney transplant

Cited by 9 publications

References 52 publications

STXBP3 and GOT2 predict immunological activity in acute allograft rejection

STXBP3 and GOT2 predict immunological activity in acute allograft rejection

Association of Intrarenal Resistance Index and Systemic Atherosclerosis After Kidney Transplantation

Association of Intrarenal Resistance Index and Systemic Atherosclerosis After Kidney Transplantation.

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