Resistive Index of Renal Grafts: Its Relation to Systemic and Renal Vascular Factors.

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Abstract

Objective

To determine the relation of intrarenal RI to systemic cardiovascular and nephropathy risk factors in renal transplant recipients (RTRs).

Objective

To establish whether RI varies according to the measurement site (interlobar or cortical arteries) to assess the influence of the vessel diameter.

Material and Methods

Vascular Doppler ultrasound of both the renal graft and carotid arteries was performed in 84 stable renal transplant patients more than 3 months post-transplant. Definition of RI: (Peak Systolic Velocity (PSV)-End Diastolic Velocity (EDV))[Fraction Slash]PSV. RI < 0.75 was determined as normal and ≥ 0.75 as increased.

Material and Methods

Carotid findings were described as intima-media thickness, as follows: normal < 1 mm, increased 1 1.4 mm, and plaque > 1.5 mm.

Results

Distribution by sex: 34 men (40, 5%), and age: 47.8 +/-13.8. Sixty-six RTRs were transplanted from cadaveric donors (CD) (78.5%), out of whom 17 were transplanted from expanded criteria donors, according to UNOS. The other 18 were transplanted from living donors (LD) (21.5%).

Results

The variables analyzed that were statistically associated with increased RI were: age 51.1 vs. 43.9, p=0.002; post-transplant time (months) 104.5 vs. 62.5, p=0.029; MDRD (ml/min) 47.5 vs. 59.3, p=0.014; previous cardiovascular events 10 vs. 2, p=0.028; and carotid plaque (≥1.5 mm) 26/44 vs. 14/40, p=0.027.

Results

When performing a multivariate analysis, the age and post-transplant time (months) variables were statistically significant, with p=0.004 and p=0.044 respectively.

Results

Diabetes and delayed graft function showed an associative trend with the highest resistive index, without reaching significant values.

Conclusion

The RI measurement site is not determining as values were similar in cortical and interlobar arteries, thus inferring that the vascular area of more distal arteries does not determine RI.

Conclusion

An increased RI would reflect the ageing of both the patient and organ, associated with cardiovascular risk factors. Further studies are needed to verify these data.

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