Resistive index and chronic allograft nephropathy evaluated in protocol biopsies as predictors of graft outcome

Introduction. The presence of chronic allograft nephropathy (CAN) in protocol biopsies is negatively associated with graft survival. Although recent studies have indicated that the resistive index (RI) is a predictor of graft failure, it does not correlate with CAN in stable grafts. We therefore stu...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2005-11, Vol.20 (11), p.2511-2516
Main Authors: Vallejos, Augusto, Alperovich, Gabriela, Moreso, Francesc, Cañas, Concepcion, de Lama, M. Eugenia, Gomà, Montserrat, Fulladosa, Xavier, Carrera, Marta, Hueso, Miguel, Grinyó, Josep M., Serón, Daniel
Format: Article
Language:English
Subjects:
Adult
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Associated diseases and complications
Biological and medical sciences
Biopsy, Needle
chronic allograft nephropathy
Chronic Disease
Diabetes. Impaired glucose tolerance
Emergency and intensive care: renal failure. Dialysis management
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Female
Follow-Up Studies
Glomerulonephritis - etiology
Glomerulonephritis - pathology
Graft Rejection - complications
Graft Rejection - pathology
Graft Survival
Humans
Intensive care medicine
Kidney Failure, Chronic - therapy
Kidney Glomerulus - pathology
Kidney Transplantation
Male
Medical sciences
Middle Aged
Prognosis
protocol biopsies
renal transplantion
resistive index
Retrospective Studies
Risk Factors
Severity of Illness Index
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Transplantation, Homologous
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Summary:Introduction. The presence of chronic allograft nephropathy (CAN) in protocol biopsies is negatively associated with graft survival. Although recent studies have indicated that the resistive index (RI) is a predictor of graft failure, it does not correlate with CAN in stable grafts. We therefore studied the relationship between RI and CAN and examined the predictive value of both parameters on graft outcome. Methods. Included were patients transplanted between 1997 and 2002 and who had protocol biopsies and RI determinations. Renal lesions were blindly evaluated according to Banff 97 criteria. Mean glomerular volume, cortical interstitial volume fraction and intimal arterial volume fraction were estimated using a point counting technique. RI was determined before biopsy in at least two different renal locations. The outcome variable was defined as graft failure or a 30% serum creatinine increase between protocol biopsy and last follow-up. Results. Eighty-seven patients were included. RI correlated with recipient age (R = 0.52, P
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/gfi041