The renal arterial resistance index and renal allograft survival
The renal arterial resistance index and renal allograft survival
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DOI：
10.1056/nejmoa022602
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发表时间：
2003-07-10
影响因子：
158.5
通讯作者：
Haller, H
中科院分区：
文献类型：
--
作者：
Radermacher, J;Mengel, M;Haller, H
背景：大多数肾移植失败的原因是慢性移植肾肾病或受体死亡，但没有可靠的因素预测长期结果已被确定。我们测试是否肾动脉阻力指数小于80是预测长期移植物survival.METHODS：肾段动脉阻力指数（舒张末期流量的百分比减少相比，收缩期流量）的多普勒超声测量601例患者至少3个月后移植1997年8月至1998年11月。所有患者均随访3年或3年以上。联合终点是肌酐清除率下降50%或更多，同种异体移植物衰竭（需要透析）或死亡。结果：共有122例患者（20%）的阻力指数为80或更高。其中84名患者（69%）肌酐清除率下降50%或更多，而479例患者中有56例阻力指数低于80（12%）; 57名患者具有较高的抵抗指数47%的患者需要透析，而43名患者的抵抗指数较低耐药指数较高的36例患者（30%）死亡，而耐药指数较低的33例患者（7%）死亡（P
BACKGROUND:Most renal transplants fail because of chronic allograft nephropathy or because the recipient dies, but no reliable factor predicting long-term outcome has been identified. We tested whether a renal arterial resistance index of less than 80 was predictive of long-term allograft survival.METHODS:The renal segmental arterial resistance index (the percentage reduction of the end-diastolic flow as compared with the systolic flow) was measured by Doppler ultrasonography in 601 patients at least three months after transplantation between August 1997 and November 1998. All patients were followed for three or more years. The combined end point was a decrease of 50 percent or more in the creatinine clearance rate, allograft failure (indicated by the need for dialysis), or death.RESULTS:A total of 122 patients (20 percent) had a resistance index of 80 or higher. Eighty-four of these patients (69 percent) had a decrease of 50 percent or more in creatinine clearance, as compared with 56 of the 479 patients with a resistance index of less than 80 (12 percent); 57 patients with a higher resistance index (47 percent) required dialysis, as compared with 43 patients with a lower resistance index (9 percent); and 36 patients with a higher resistance index (30 percent) died, as compared with 33 patients with a lower resistance index (7 percent) (P