title: Quantified power Doppler as a predictor of delayed graft function after renal transplantation.
abstract: OBJECTIVE
  No safe ultrasound (US) parameters have been established to differentiate the causes of graft dysfunction.
  
  
  OBJECTIVE
  To define US parameters and identify the predictors of normal graft evolution, delayed graft function (DGF), and rejection at the early period after kidney transplantation.
  
  
  METHODS
  Between June 2012 and August 2013, 79 renal transplant recipients underwent US examination 1-3 days posttransplantation. Resistive index (RI), power Doppler (PD), and RI + PD (quantified PD) were assessed. Patients were allocated into three groups: normal graft evolution, DGF, and rejection.
  
  
  RESULTS
  Resistive index of upper and middle segments and PD were higher in the DGF group than in the normal group. ROC curve analysis revealed that RI + PD was the index that best correlated with DGF (cutoff = 0.84). In the high RI + PD group, time to renal function recovery (6.33 ± 6.5 days) and number of dialysis sessions (2.81 ± 2.8) were greater than in the low RI + PD group (2.11 ± 5.3 days and 0.69 ± 1.5 sessions, respectively), p = 0.0001. Multivariate analysis showed that high donor final creatinine with a relative risk (RR) of 19.7 (2.01-184.7, p = 0.009) and older donor age (RR = 1.17 (1.04-1.32), p = 0.007) correlated with risk DGF.
  
  
  CONCLUSIONS
  Quantified PD (RI + PD) was the best DGF predictor. PD quantification has not been previously reported.
authors.affiliation: Department of Internal Medicine-UNESP, Univ Estadual Paulista, Rubião Jr, S/N, Botucatu, São Paulo, 18.618-970, Brazil.
authors.forename: Mariana Moraes
authors.initials: MM
authors.lastname: Contti
authors.forename: Paula Dalsoglio
authors.initials: PD
authors.lastname: Garcia
authors.forename: Cristiane Akemi
authors.initials: CA
authors.lastname: Kojima
authors.forename: Hong Si
authors.initials: HS
authors.lastname: Nga
authors.forename: Maria Fernanda Cordeiro
authors.initials: MF
authors.lastname: de Carvalho
authors.forename: Luis Gustavo Modelli
authors.initials: LG
authors.lastname: de Andrade
mesh_terms: D000328:Adult; D000367:Age Factors; D001783:Blood Flow Velocity; D003404:Creatinine / Q000097:blood; D051799:Delayed Graft Function / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006084:Graft Rejection / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012077:Renal Artery; D012307:Risk Factors; D014019:Tissue Donors; D018615:Ultrasonography, Doppler, Color / Q000379:methods; D014655:Vascular Resistance; D055815:Young Adult
chemical_list: D003404:Creatinine