Early measurement of renal arterial resistance index after kidney transplantation and its influence on long-term renal allograft survival
彩色多普勒超声检测肾移植术后早期动脉阻力指数及其对远期预后的影响

Objective To investigate whether the renal arterial resistance index（RI） measured early by color Doppler ultrasound after kidney transplantation has any influence on renal allograft survival.Methods We retrospectively analyzed 317 cadaver kidney transplant patients who underwent RI evaluation within the first month with stable renal function during January 2004 to December 2006.All the patients were subdivided into two groups according to the RI median value,namely group A with RI﹤median value and group B with RI ≥ median value.Then Logistic regression analysis was used to assess and rank the relative risk of potential variables on RI,such as donor age,cold ischemia time,human leukocyte antigen（HLA） mismatch,recipient age,gender,systolic blood pressure,diastolic blood pressure,pulse pressure,serum creatinine,serum cholesterol,ciclosporin or tacrolimus trough level,arterial blood pressure,number of HLA mismatches and anti-hypertensive medications and proteinuria.Cox proportional hazard analysis was employed to assess the renal allograft survival between two group.Results Group A and B included 144 and 173 patients,respectively,according to median RI value of 0.64.The relative risk factors on RI value were both recipient age and proteinuria with the other variances excluded.Considering a serum creatinine increase 50% as the endpoint of this study,there are 12 and 42 patients reached the endpoint in group A and group B respectively by the end of the 2008.Group B showed a statistically lower graft survival compared with group A by Cox proportional hazard analysis.Conclusion Early determination of RI can help predict long-term graft survival in kidney transplant recipients