title: Value of the resistive index in patient and graft survival after kidney transplant.
abstract: BACKGROUND
  The resistive index (RI) obtained by performing doppler sonography is a hemodynamic index commonly used to measure flow resistance within an organ to assess if there is a vascular disease associated with that organ. It is a well-known predictor of kidney transplant outcome. The purpose of this study was to analyze the impact of RI values on patient and graft survival, as well as kidney graft function during 5-year follow-up.
  
  
  METHODS
  We retrospectively investigated 761 kidney transplant recipients from cadaveric donors performed between 1998 to 2011. RI was measured at hospital discharge after the kidney transplant. All the patients were divided into tertiles, according to the baseline RI value (group 1: RI < 0.70, group 2: RI between 0.70 and 0.79 and group 3: RI > 0.80).
  
  
  RESULTS
  Patients with a low RI (<0.70) showed the lowest incidence of delayed graft function (DGF) compared to the other two groups (20.2% vs. 32.2% vs. 33%). Recipients with low RI values displayed significantly better creatinine clearance (70 vs. 55 vs 35 ml/min, respectively) than those with medium or high RI values at 5-year follow-up. Kaplan-Meier estimates of cumulative graft survival were significantly worse in patients who had a RI of 0.70 or more than in patients with a RI of less than 0.70 (p = 0.02). Cumulative patient survival showed the same behavior (0.01)
  
  
  CONCLUSIONS
  Low RI values measured in segmental arteries in the very early post-transplant period predict better kidney graft function and reduce the risk of all-cause graft loss, including patient death in a 5-year follow-up period.
authors: Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. stefanovittorio@gmail.com
authors: Stefano Vittorio
authors: SV
authors: Impedovo
authors: Pasquale
authors: P
authors: Martino
authors: Silvano
authors: S
authors: Palazzo
authors: Pasquale
authors: P
authors: Ditonno
authors: Michele
authors: M
authors: Tedeschi
authors: Floriana
authors: F
authors: Giangrande
authors: Carlos
authors: C
authors: Miacola
authors: Saverio
authors: S
authors: Forte
authors: Francesco Paolo
authors: FP
authors: Selvaggi
authors: Michele
authors: M
authors: Battaglia
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies; D014655:Vascular Resistance; D055815:Young Adult