Renal transplantation is the treatment of choice for end-stage renal disease in regard to morbidity, mortality and quality of life. Following transplantation, cardiovascular disease is the main cause of mortality and an increased renal allograft resistive index (RI) is associated with patient survival. We suggest to examine the predictive value of intrarenal RI on presence of atherosclerotic diseases. Between 1999-2001 years, 97 patients who underwent renal transplantation and with stable renal function were included in the study. The patients who had renal artery stenosis, evidence of urinary tract obstruction, clinical signs acute rejection and chronic allograft nephropathy were excluded. The clinical and laboratory parameters were obtained on each patient from the hospital records: demographic features, medications, serum creatinine, lipid parameters, body mass index (BMI), systolic and diastolic blood pressure, pulse pressure (PP), mean arterial pressure (MAP). At the time of study, intrarenal RI and carotid intima-media thickness (CIMT) were measured by Doppler ultrasonography. Estimated glomerular filtration rate was calculated according to the simplified version of the Modification of Diet in Renal Disease (MDRD). In linear regression analysis, RI was significantly correlated with recipient age (Beta=, 0.321, p= 0.001), C-reactive protein (Beta=0.260, p=0.010), systolic blood pressure (Beta=0.380, p=0.00), PP (Beta=0.567, p=0.00), BMI (Beta= 0.220, p=0.035) and CIMT (Beta=0.264, p=0.009). Multivariate linear regression analysis demonstrated that only PP (Beta= 0.518; p=0.00) was independent predictive value for intrarenal RI. Intrarenal RIs are associated with traditional cardiovascular risk factors such as age, increased PP and systolic pressure. In patients with stable renal function, renal RIs have been associated carotid atherosclerosis assessed as CIMT. We found that increased intrarenal graft RI may predict presence of cardiovascular disease in noncompliant renal transplant recipients.
Volume : 6
Issue : 4
Pages : 143
Department of Nephrology1, Department of General Surgery2, Baskent University Faculty of Medicine, Ankara, Turkey