Atherosclerosis and Intrarenal Resistance Index in Kidney Transplant Recipients.

Autor:	Bloemendal NT; Department of Surgery, Division of Organ Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Hertsig R; Department of Surgery, Division of Organ Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Benjamens S; Department of Surgery, Division of Organ Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., van de Kuit A; Department of Surgery, Division of Organ Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Swaab T; Department of Surgery, Division of Organ Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Yakar D; Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Minnee RC; Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC University Medical Center, Rotterdam, The Netherlands., Tielliu IFJ; Department of Surgery, Division of Vascular Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Bakker SJL; Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Pol RA; Department of Surgery, Division of Organ Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2023 Jan 12; Vol. 9 (2), pp. e1435. Date of Electronic Publication: 2023 Jan 12 (Print Publication: 2023).
DOI:	10.1097/TXD.0000000000001435
Abstrakt:	Atherosclerosis of the aortoiliac vessels can adversely affect kidney perfusion after kidney transplantation. Atherosclerosis severity can be determined using the calcium score (CaScore). Potential problems with posttransplantation kidney perfusion can be determined using the intrarenal resistance index (RI). This study investigated the association between aortoiliac CaScore and RI in kidney transplant recipients. Methods: Kidney transplant recipients (2004-2019), for whom the CaScore and RI were determined, were included in this dual-center cohort study. CaScore was measured in 3 aortoiliac segments using noncontrast CT imaging. RI was determined using Doppler ultrasound. Multivariable linear regression analyses were performed between the CaScore and RI, adjusted for confounding variables. Results: The mean age of the 389 included patients was 59 (±13) y. The mean RI (unitless) was 0.71 (±0.09)' and the median CaScore (unitless) was 3340 (399-7833). In univariable linear regression analyses with RI as the dependent variable, CaScore ( β = 0.011; P < 0.001) was positively associated with RI. Moreover, recipient age ( β = 0.014; P < 0.001), history of diabetes ( β = 0.029; P = 0.003), recipient history of vascular interventions ( β = 0.032; P = 0.002), prior dialysis ( β = 0.029; P = 0.003), deceased donor transplantation ( β = 0.042; P < 0.001), donation after cardiac death ( β = 0.036; P = 0.001), an increase in cold ischemia time ( β = 0.011; P < 0.001), and the Comprehensive Complication Index ( β = 0.006; P = 0.002) were also positively associated with RI, whereas preoperative recipient diastolic blood pressure ( β = -0.007; P = 0.030) was inversely associated. In multivariable analyses, CaScore and RI remained significantly ( P = 0.010) associated, independent of adjustment for potential confounders. Furthermore, in univariable linear regression analyses, multiple graft function characteristics were associated with RI. Conclusions: A significant association was found between CaScore and RI, independent of adjustment for multiple potential confounding factors, leading to a better insight into the development and interpretation of RI. Aortoiliac atherosclerosis should be considered when interpreting the RI and determining the possible cause of malperfusion and graft failure after kidney transplantation. Competing Interests: The authors declare no funding or conflicts of interest. (Copyright © 2023 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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