Renal vascular resistance measured by doppler sonography in the early period after kidney transplantation as a predictor of graft loss and chronic graft dysfunction – a 5 years follow-up study
A Kolonko, J Chudek, A Więcek
Ann Transplant 2009; 14(1): 25-25
Background: Resistive index (RI) measured by Doppler sonography during the early post-transplant period reï¬‚ects interstitial oedema within the transplanted kidney. In the present, prospective study we have analysed the inï¬‚uence of RI measured shortly after KTx on graft survival and kidney function during the 5 years follow-up period.
Material/Methods: RI was measured at 2[sup]nd[/sup]-4[sup]th[/sup] day after KTx in 323 out of 333 consecutive patients transplanted in our Centre. Nineteen patients with primary non-functioning graft were excluded from the study. Remaining 304 patients were divided into two groups: first, consisted of 113 patients with RI values below 0.75, and the second one (N=191) with RI equal or above 0.75. The kidney graft function was analyzed using the MDRD formula after 3 months and every 6 months after KTx.
Results: During the 5 years follow-up period 21 patients died (4 in group I and 17 in group II) and 46 lost their kidney graft, 11 in group I and 35 in group II. There was an 8.6% difference in 5-years graft survival with the worse outcome in group II [HR of graft loss 1.98(1.02-3.35); p=0.044]. Patients in group II were characterized by lower eGFR calculated at 3 months post KTx [48.7(46.0-51.5) vs. 60.9(56.8-65.0) ml/min/1.73 m2; p<0.001].
Conclusions: High intrarenal vascular resistance demonstrated by Doppler
sonography shortly after KTx increases the risk of chronic graft dysfunction and almost doubles the likelihood of graft loss during the 5 years follow-up period.
Keywords: Kidney Transplantation, Organ Perfusion