Mediha Boran1, Muharrem Tola2, Ertay Boran3, Mertay Boran4. 1. Department of Nephrology, Hemodialysis and Transplantation, Turkiye Higher Education Hospital Ankara, Turkey. 2. Department of Radiology, Turkiye Higher Education Hospital Ankara, Turkey. 3. Department of Anesthesiology and Reanimation, Duzce University Faculty of Medicine Duzce, Turkey. 4. Department of Thoracic Surgery, Duzce University Faculty of Medicine Duzce, Turkey.
Abstract
OBJECTIVE: Renal Doppler Ultrasound (RDU) indices: resistive index (RI) and pulsatility index (PI) are frequently applied as a noninvasive method that measured possible causes of allograft dysfunction in kidney transplant patients. We aimed to compare long-term prognosis and associated risk factors including the RDU markers in recipients with and without new-onset diabetes after transplantation (NODAT) beyond 5 years after kidney transplantation. METHODS: A prospectively maintained database of 137 kidney allograft recipients, transplanted in a single center, maintained on reduced tacrolimus-based immunosuppressive regimen and angiotensin receptor blocker (ARB) was retrospectively analyzed. The assessment including incidence of NODAT and associated risk factors including RI and PI was compared between 12 recipients with and 125 recipients without NODAT median 77.5 months and 74 months, respectively, after kidney transplantation. RESULTS: NODAT was detected in 12 (9.6%) of the 137 kidney transplant recipients, without gender predilection. In univariate regression analysis recipient age (P < 0.001), recipients weight at the time of NODAT ≥ 65 kg (P < 0.001), as well as proteinuria (P = 0.026), tacrolimus trough levels (P = 0.005), PI (P = 0.023) were associated with the long-term risk of NODAT and multivariate regression analysis also revealed that recipients weight at the time of NODAT ≥ 65 kg (P = 0.004) was independent long- term risk factor for NODAT. CONCLUSIONS: Our study demonstrated that beyond 5 years after kidney transplantation the RDU indices: RI and PI are not long-term risk factors for NODAT and the correction of recipient's body weight, the treatment with ARB and maintained reduced TAC doses lowered the incidence of NODAT.
OBJECTIVE: Renal Doppler Ultrasound (RDU) indices: resistive index (RI) and pulsatility index (PI) are frequently applied as a noninvasive method that measured possible causes of allograft dysfunction in kidney transplant patients. We aimed to compare long-term prognosis and associated risk factors including the RDU markers in recipients with and without new-onset diabetes after transplantation (NODAT) beyond 5 years after kidney transplantation. METHODS: A prospectively maintained database of 137 kidney allograft recipients, transplanted in a single center, maintained on reduced tacrolimus-based immunosuppressive regimen and angiotensin receptor blocker (ARB) was retrospectively analyzed. The assessment including incidence of NODAT and associated risk factors including RI and PI was compared between 12 recipients with and 125 recipients without NODAT median 77.5 months and 74 months, respectively, after kidney transplantation. RESULTS: NODAT was detected in 12 (9.6%) of the 137 kidney transplant recipients, without gender predilection. In univariate regression analysis recipient age (P < 0.001), recipients weight at the time of NODAT ≥ 65 kg (P < 0.001), as well as proteinuria (P = 0.026), tacrolimus trough levels (P = 0.005), PI (P = 0.023) were associated with the long-term risk of NODAT and multivariate regression analysis also revealed that recipients weight at the time of NODAT ≥ 65 kg (P = 0.004) was independent long- term risk factor for NODAT. CONCLUSIONS: Our study demonstrated that beyond 5 years after kidney transplantation the RDU indices: RI and PI are not long-term risk factors for NODAT and the correction of recipient's body weight, the treatment with ARB and maintained reduced TAC doses lowered the incidence of NODAT.
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