Significant increase in 1-year posttransplant renal arterial index predicts graft loss.
OBJECTIVE
Conflicting data have been reported concerning the use of kidney graft arterial resistance index (RI) measured by Doppler to predict death-censored graft loss. We hypothesized that changes in RI values could carry better information than a single measure of RI.


METHODS
Four hundred twenty-five renal transplant recipients were included in the study. We tested whether changes in renal arterial resistance index between 4 and 12 months after transplant (ΔRI(4→12)) were predictive of graft loss.


RESULTS
Neither 4-month nor 1-year RI predicted graft loss. The area under the receiver operating characteristics curve of ΔRI(4→12) for graft loss was 0.75. A ΔRI(4→12) ≥10% had the best sensitivity and specificity. One year after transplant, 22% of the study population had ΔRI(4→12) ≥10%. Fifty-five patients (12.9%) experienced graft loss during follow-up. The annual incidence of graft loss was higher in patients with ΔRI(4→12) ≥10% (3.5 versus 1.3%; P = 0.009). In multivariate analysis, patients with ΔRI(4→12) ≥10% had an increased risk of graft loss (hazard ratio, 6.21; 95% confidence interval, 1.99 to 22.15; P = 0.002).


CONCLUSIONS
A variation in RI ≥10% in the first year after transplant is an independent risk factor for death-censored graft loss in renal transplant recipients.
Loock
Mélanie Terebus
MT
Department of Radiology, CHU Saint Jacques, Besançon, France.
Bamoulid
Jamal
J
Courivaud
Cécile
C
Manzoni
Philippe
P
Simula-Faivre
Dominique
D
Chalopin
Jean-Marc
JM
Kastler
Bruno
B
Ducloux
Didier
D
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005602:France; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance