Resistive index cannot predict transplant kidney function

Chiang, Yi‐Hsuan; Chu, Shu Hsun; Chuang, Cheng-Keng; Chen, H.-W; Chou, Chung Chuan; Chen, Yi-Lang; Wu, Chao‐Yi

doi:10.1016/s0041-1345(02)03802-2

Cited by 19 publications

(15 citation statements)

References 5 publications

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“…Thus, we believe that a very high cut-off, if predictive of graft loss, is probably not relevant because it selects a small subset of patients. Moreover, some other studies did not confirm these results (10,11). It should be noted that RI did not depend on either donor characteristics or past transplant events.…”

Section: Discussionmentioning

confidence: 78%

Significant Increase in 1-Year Posttransplant Renal Arterial Index Predicts Graft Loss

Loock¹,

Bamoulid²,

Courivaud³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: Conflicting data have been reported concerning the use of kidney graft arterial resistance index (RI) measured by Doppler to predict death-censored graft loss. We hypothesized that changes in RI values could carry better information than a single measure of RI.Design, setting, participants, & measurements: Four hundred twenty-five renal transplant recipients were included in the study. We tested whether changes in renal arterial resistance index between 4 and 12 months after transplant (⌬RI 4312 ) were predictive of graft loss.Results: Neither 4-month nor 1-year RI predicted graft loss. The area under the receiver operating characteristics curve of ⌬RI 4312 for graft loss was 0.75. A ⌬RI 4312 >10% had the best sensitivity and specificity. One year after transplant, 22% of the study population had ⌬RI 4312 >10%. Fifty-five patients (12.9%) experienced graft loss during follow-up. The annual incidence of graft loss was higher in patients with ⌬RI 4312 >10% (3.5 versus 1.3%; P ‫؍‬ 0.009). In multivariate analysis, patients with ⌬RI 4312 >10% had an increased risk of graft loss (hazard ratio, 6.21; 95% confidence interval, 1.99 to 22.15; P ‫؍‬ 0.002).Conclusions: A variation in RI >10% in the first year after transplant is an independent risk factor for death-censored graft loss in renal transplant recipients.

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Section: Discussionmentioning

confidence: 78%

Significant Increase in 1-Year Posttransplant Renal Arterial Index Predicts Graft Loss

Loock¹,

Bamoulid²,

Courivaud³

et al. 2010

Clinical Journal of the American Society of Nephrology

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“…17 On the other hand, many studies failed to show a role for these indices for predicting of allograft rejection. 7,24,25 However, complicated patients including those with acute tubular necrosis, acute rejection, delayed function, and cyclosporine toxicity were not excluded from some of these studies, which partly may explain the discrepancy between these studies' findings and those that support the use of RI and PI for predicting renal graft dysfunction. 22 In the present study, we also excluded complicated cases and obtained results supporting the value of these indices for predicting renal allograft function.…”

Section: Discussionmentioning

confidence: 99%

Relation of Resistive and Pulsatility Indices With Graft Function After Renal Transplant

Ghorbani

Shirazi²,

Sametzadeh³

et al. 2012

Exp Clin Transplant

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Objectives: There are conflicting data regarding the use of some measured indices by Doppler ultrasound such as the resistive index and the pulsatility index in predicting renal allograft dysfunction. This study sought to evaluate the association of early postoperative Doppler indices and 3-month serum creatinine levels in renal transplant recipients. Materials and Methods: During a 1-year period, all patients who underwent renal transplant at our hospital were recruited into a prospective study. Doppler ultrasound was performed on all patients 6 days and 3 months after the transplant and the resistive index and the pulsatility index were calculated for each patient. Then, the association between these indices and 3-month outcomes of patients were investigated. Results: Thirty-eight patients including 21 men (mean age, 36.6 ± 13.1 y) were evaluated. There was a positive correlation between the resistive index and the pulsatility index at 6 days after transplant and the serum creatinine measured at the same day (P < .001 and r=0.570 for resistive index; P < .001 and r=0.547 for pulsatility index). There was also a positive correlation between the pulsatility index and the resistive index at 6 days after transplant and 3-month serum creatinine level (P = .009 and r=0.420 for resistive index; P = .009 and r=0.417 for pulsatility index). There were negative correlations between the resistive index and the pulsatility index on the sixth day after surgery and creatinine clearance measured at 6 days and 3 months after transplant. Conclusions: This study reveals a strong-to-medium correlation between the resistive index and the pulsatility index, serum creatinine level, measured 6 days after transplant.

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“…Both at early stages after transplantation or later on, RI has a significant direct correlation with Cr [3,9,10,12,14,19] and inverse correlation with GFR estimated by Cr clearance [1,9,12,20]. By contrast, some studies did not find this relationship [11,15,17,18]. In our report, RI was related to day-2 Cr, day-5 Cr, initial diuresis and to a functional marker of early graft damage such as CRR2 [24,34].…”

Section: Discussionmentioning

confidence: 99%

“…In a prospective study, Radermacher et al [9] demonstrated that an RI of 0.8 or higher measured at least three months after transplantation was associated with poor allograft outcome independently of other established risk factors, though it is not known whether early RI is also related with long-term outcome. Several reports have related RI, measured at different moments after transplantation, with renal allograft function, although there are also conflicting findings [1,3,9,10,11,12,13,14,15,16,17,18,19,20]. The relationship between RI and transplant function and outcome may reflect intra-renal damage that can be of interest for evaluating the graft adequately.…”

Section: Introductionmentioning

confidence: 99%

Determinants of Resistive Index Shortly after Transplantation: Independent Relationship with Delayed Graft Function

Rodrigo¹,

López-Rasines

Ruiz³

et al. 2009

Nephron Clin Pract

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Measurement of the vascular resistive index (RI) by Doppler ultrasonography has been proposed as a non-invasive method to evaluate renal allograft dysfunction, but there are conflicting reports about its clinical utility. The aim of our study was to analyse the donor and recipient characteristics related to RI measured at days 2 and 3 after renal transplantation and the relationship between RI and allograft outcome. RI was measured by Doppler ultrasonography in 333 patients at days 2 or 3 post-transplantation. Donor and recipient variables and allograft outcome were collected from a prospectively maintained institutional database. In patients with RI higher than 0.7, donor age, recipient age, duration of renal replacement therapy, incidence of diabetes, hypertension and atherosclerosis in the recipient, pulse pressure, initial creatinine and the incidence of delayed graft function (DGF) were higher. After multivariate analysis, the only variables that remained significant for an increased risk of higher RI were recipient age over 55 years, presence of diabetes in the recipient and DGF. Recipient age, previous diabetes mellitus and DGF are the most important determinants of transplant kidney RI in the first days after transplantation. So both the graft recipient and the graft itself, but not the donor, determine intra-renal Doppler indices.

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Resistive index cannot predict transplant kidney function

Cited by 19 publications

References 5 publications

Significant Increase in 1-Year Posttransplant Renal Arterial Index Predicts Graft Loss

Significant Increase in 1-Year Posttransplant Renal Arterial Index Predicts Graft Loss

Relation of Resistive and Pulsatility Indices With Graft Function After Renal Transplant

Determinants of Resistive Index Shortly after Transplantation: Independent Relationship with Delayed Graft Function

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