No effect of pretransplantation bilateral nephrectomy on the resistive indices measured in the kidney allograft.
BACKGROUND
The cirrhotic kidney is the cause of sympathetic nervous system and the renin-angiotensin system activation leading to increased vascular resistance and arterial hypertension. The impact of unilateral or bilateral nephrectomy (UN or BN) performed before kidney transplantation on kidney graft intrarenal resistance has not been assessed yet. The aim of this study is to assess the intrarenal resistance parameters measured by Doppler ultrasound in the transplanted kidney in either nephrectomized or non-nephrectomized kidney transplant recipients.


METHODS
Among 686 consecutive successful first cadaveric kidney graft recipients transplanted from 1998 to 2012, we identified 43 patients who underwent BN and 49 patients who underwent UN. Patients with acute rejection episodes within an early post-transplantation period were excluded. We have analyzed both pulsatility (PI) and resistance (RI) indices measured within the kidney graft before discharge from the hospital.


RESULTS
The prevalence of hypertension in the follow-up period after transplantation was significantly lower in the BN group (65.1% versus 81.0% in other groups). Neither BN nor UN influenced the PI or RI values. The mean PI and RI values were 1.50 (1.38-1.61) and 0.75 (0.73-0.78) in BN, 1.48 (1.37-1.58) and 0.76 (0.73-0.79) in UN, and 1.47 (1.43-1.50) and 0.74 (0.73-0.75) in non-nephrectomized patients, respectively. The results of multivariate analysis confirmed the lack of influence of nephrectomy on kidney graft resistive indices.


CONCLUSIONS
BN before transplantation resulted in lower frequency of hypertension, but it did not affect the intrarenal vascular resistance measured in the kidney graft.
Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.
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Kujawa-Szewieczek
Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland.
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Kolonko
Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland; Department of Pathophysiology, Medical University of Silesia, Katowice, Poland.
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Chudek
Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland. Electronic address: awiecek@sum.edu.pl.
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Więcek
D000328:Adult; D064591:Allografts; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000453:epidemiology; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D057234:Preoperative Period; D018608:Ultrasonography, Doppler; D014655:Vascular Resistance