Renal transplantation is the treatment of choice for end-stage renal disease in regards 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 examining the predictive value of intrarenal RI on present 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, with cyclosporine toxicicity after transplantation 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 blood pressure, diastolic blood pressure, pulse pressure (PP), mean arterial pressure (MAP) and measurement of intrarenal RI by Doppler ultrasonography (US). At study entry, blood was taken from all subjects under standardized conditions. Estimated glomerular filtration rate was calculated according to the simplified version of the Modification of Diet in Renal Disease (MDRD). The intima-media thickness of the common carotid artery (CIMT) was measured and Doppler US had been performed for calculation of intrarenal graft RI at the time of the study. In linear regression analysis, RI was significantly correlated with recipient age (Beta=, 0.321, p= 0.001) CRP (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 a complex integration of arterial compliance, arterial pulsatility, and peripheral resistance, which are associated with traditional cardiovascular risk factors and with the presence of atherosclerotic disease. In patients with stable renal function, renal RIs have been associated with carotid atherosclerosis assessed as carotid intima-media thickness We found that increased intrarenal graft RI may predict present of cardiovascular disease in noncomplice renal transplant recipients.
Volume : 6
Issue : 4
Pages : 222
Departments of Nephrology1 and General Surgery2, Baskent University Faculty of Medicine, Ankara, Turkey