Jean-Baptiste de Freminville1,2, Louis-Marie Vernier3, Jérome Roumy4,5, Frédéric Patat6,4,5, Philippe Gatault7,6,8, Bénédicte Sautenet7,6, Christelle Barbet7, Hélène Longuet7, Elodie Merieau7, Matthias Buchler7,6,8, Jean-Michel Halimi7,6,8. 1. Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, Tours, France. jean.de-freminville@polytechnique.org. 2. University of Tours, Tours, France. jean.de-freminville@polytechnique.org. 3. Néphrologie-Dialyse, Centre de santé pluridisciplinaire, Le Mans, France. 4. Imagerie Médicale, Hôpital Bretonneau, CHU Tours, Tours, France. 5. CIC-IT 1415, CHU Tours, Tours, France. 6. University of Tours, Tours, France. 7. Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, Tours, France. 8. EA4245, University of Tours, Tours, France.
Abstract
BACKGROUND: Renal resistive index (RI) predicts mortality in renal transplant recipients (RTR). However, its predictive value may be different according to the time of measurement. We analysed RI changes between 1 month and 3 months after transplantation and its predictive value for death with a functioning graft (DWFG). METHODS: We conducted a retrospective study in 1685 RTR between 1985 and 2017. The long-term predictive value of changes in RI value from 1 month to 3 months was assessed in diabetic and non-diabetic RTR. RESULTS: Best survival was observed in RTR with RI < 0.70 both at 1 and 3 months, and the worst survival was found in RTR with RI ≥ 0.70 both at 1 and 3 months (HR = 3.77, [2.71-5.24], p < 0.001). The risk of DWFG was intermediate when RI was < 0.70 at 1 month and ≥ 0.70 at 3 months (HR = 2.15 [1.29-3.60], p = 0.003) and when RI was ≥0.70 at 1 month and < 0.70 at 3 months (HR = 1.90 [1.20-3.03], p = 0.006). In diabetic RTR, RI was significantly associated with an increased risk of death only in those with RI < 0.70 at 1 month and ≥ 0.70 at 3 months (HR = 4.69 [1.07-20.52], p = 0.040). RI considered as a continuous variable at 1 and 3 months was significantly associated with the risk of DWFG in nondiabetic but not in diabetic RTR. CONCLUSION: RI changes overtime and this impacts differently diabetic and nondiabetic RTR. RI short-term changes have a strong prognosis value and refines the risk of DWFG associated with RI.
BACKGROUND: Renal resistive index (RI) predicts mortality in renal transplant recipients (RTR). However, its predictive value may be different according to the time of measurement. We analysed RI changes between 1 month and 3 months after transplantation and its predictive value for death with a functioning graft (DWFG). METHODS: We conducted a retrospective study in 1685 RTR between 1985 and 2017. The long-term predictive value of changes in RI value from 1 month to 3 months was assessed in diabetic and non-diabetic RTR. RESULTS: Best survival was observed in RTR with RI < 0.70 both at 1 and 3 months, and the worst survival was found in RTR with RI ≥ 0.70 both at 1 and 3 months (HR = 3.77, [2.71-5.24], p < 0.001). The risk of DWFG was intermediate when RI was < 0.70 at 1 month and ≥ 0.70 at 3 months (HR = 2.15 [1.29-3.60], p = 0.003) and when RI was ≥0.70 at 1 month and < 0.70 at 3 months (HR = 1.90 [1.20-3.03], p = 0.006). In diabetic RTR, RI was significantly associated with an increased risk of death only in those with RI < 0.70 at 1 month and ≥ 0.70 at 3 months (HR = 4.69 [1.07-20.52], p = 0.040). RI considered as a continuous variable at 1 and 3 months was significantly associated with the risk of DWFG in nondiabetic but not in diabetic RTR. CONCLUSION: RI changes overtime and this impacts differently diabetic and nondiabetic RTR. RI short-term changes have a strong prognosis value and refines the risk of DWFG associated with RI.
Authors: Jörg Radermacher; Michael Mengel; Sebastian Ellis; Stephan Stuht; Markus Hiss; Anke Schwarz; Ute Eisenberger; Michael Burg; Friedrich C Luft; Wilfried Gwinner; Hermann Haller Journal: N Engl J Med Date: 2003-07-10 Impact factor: 91.245
Authors: D Boeri; L E Derchi; C Martinoli; G Simoni; L Sampietro; D Storace; L Ponte; C Calvi; M Repetto; C Robaudo; M Maiello Journal: Diabetologia Date: 1998-01 Impact factor: 10.122
Authors: Luís Meira-Machado; Carmen Cadarso-Suárez; Francisco Gude; Artur Araújo Journal: Comput Math Methods Med Date: 2013-12-12 Impact factor: 2.238