Resistive index and chronic allograft nephropathy evaluated in protocol biopsies as predictors of graft outcome
Introduction. The presence of chronic allograft nephropathy (CAN) in protocol biopsies is negatively associated with graft survival. Although recent studies have indicated that the resistive index (RI) is a predictor of graft failure, it does not correlate with CAN in stable grafts. We therefore stu...
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| creator | Vallejos, Augusto Alperovich, Gabriela Moreso, Francesc Cañas, Concepcion de Lama, M. Eugenia Gomà, Montserrat Fulladosa, Xavier Carrera, Marta Hueso, Miguel Grinyó, Josep M. Serón, Daniel |
| description | Introduction. The presence of chronic allograft nephropathy (CAN) in protocol biopsies is negatively associated with graft survival. Although recent studies have indicated that the resistive index (RI) is a predictor of graft failure, it does not correlate with CAN in stable grafts. We therefore studied the relationship between RI and CAN and examined the predictive value of both parameters on graft outcome. Methods. Included were patients transplanted between 1997 and 2002 and who had protocol biopsies and RI determinations. Renal lesions were blindly evaluated according to Banff 97 criteria. Mean glomerular volume, cortical interstitial volume fraction and intimal arterial volume fraction were estimated using a point counting technique. RI was determined before biopsy in at least two different renal locations. The outcome variable was defined as graft failure or a 30% serum creatinine increase between protocol biopsy and last follow-up. Results. Eighty-seven patients were included. RI correlated with recipient age (R = 0.52, P |
| doi_str_mv | 10.1093/ndt/gfi041 |
| format | Article |
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Eugenia ; Gomà, Montserrat ; Fulladosa, Xavier ; Carrera, Marta ; Hueso, Miguel ; Grinyó, Josep M. ; Serón, Daniel</creator><creatorcontrib>Vallejos, Augusto ; Alperovich, Gabriela ; Moreso, Francesc ; Cañas, Concepcion ; de Lama, M. Eugenia ; Gomà, Montserrat ; Fulladosa, Xavier ; Carrera, Marta ; Hueso, Miguel ; Grinyó, Josep M. ; Serón, Daniel</creatorcontrib><description>Introduction. The presence of chronic allograft nephropathy (CAN) in protocol biopsies is negatively associated with graft survival. Although recent studies have indicated that the resistive index (RI) is a predictor of graft failure, it does not correlate with CAN in stable grafts. We therefore studied the relationship between RI and CAN and examined the predictive value of both parameters on graft outcome. Methods. Included were patients transplanted between 1997 and 2002 and who had protocol biopsies and RI determinations. Renal lesions were blindly evaluated according to Banff 97 criteria. Mean glomerular volume, cortical interstitial volume fraction and intimal arterial volume fraction were estimated using a point counting technique. RI was determined before biopsy in at least two different renal locations. The outcome variable was defined as graft failure or a 30% serum creatinine increase between protocol biopsy and last follow-up. Results. Eighty-seven patients were included. RI correlated with recipient age (R = 0.52, P<0.0001), diastolic blood pressure (R = −0.36, P = 0.0006), pulse pressure index (R = 0.27, P = 0.009) and g-score for histological glomerulitis (ρ = 0.30, P = 0.0054), but there were no correlations between RI and chronic Banff scores or any morphometric parameter. The presence of CAN (relative risk, 3.5; 95% confidence interval 1.2–10.2; P = 0.02) but not RI was associated with the outcome variable. Conclusion. RI was associated with surrogate measures of vascular compliance such as recipient age and pulse pressure index but not with chronic allograft damage, even when it was evaluated by histomorphometry. Our results indicate that histology may be superior to RI in predicting graft function deterioration, at least in patients with stable renal function.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfi041</identifier><identifier>PMID: 16077142</identifier><identifier>CODEN: NDTREA</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Associated diseases and complications ; Biological and medical sciences ; Biopsy, Needle ; chronic allograft nephropathy ; Chronic Disease ; Diabetes. Impaired glucose tolerance ; Emergency and intensive care: renal failure. Dialysis management ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Female ; Follow-Up Studies ; Glomerulonephritis - etiology ; Glomerulonephritis - pathology ; Graft Rejection - complications ; Graft Rejection - pathology ; Graft Survival ; Humans ; Intensive care medicine ; Kidney Failure, Chronic - therapy ; Kidney Glomerulus - pathology ; Kidney Transplantation ; Male ; Medical sciences ; Middle Aged ; Prognosis ; protocol biopsies ; renal transplantion ; resistive index ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Transplantation, Homologous</subject><ispartof>Nephrology, dialysis, transplantation, 2005-11, Vol.20 (11), p.2511-2516</ispartof><rights>2005 INIST-CNRS</rights><rights>Copyright Oxford University Press(England) Nov 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c380t-e1fa6eee953a5e7e7b6dbceee1e963e313c0392be4d86b46a25b771dce3e80b73</citedby><cites>FETCH-LOGICAL-c380t-e1fa6eee953a5e7e7b6dbceee1e963e313c0392be4d86b46a25b771dce3e80b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17262746$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16077142$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vallejos, Augusto</creatorcontrib><creatorcontrib>Alperovich, Gabriela</creatorcontrib><creatorcontrib>Moreso, Francesc</creatorcontrib><creatorcontrib>Cañas, Concepcion</creatorcontrib><creatorcontrib>de Lama, M. Eugenia</creatorcontrib><creatorcontrib>Gomà, Montserrat</creatorcontrib><creatorcontrib>Fulladosa, Xavier</creatorcontrib><creatorcontrib>Carrera, Marta</creatorcontrib><creatorcontrib>Hueso, Miguel</creatorcontrib><creatorcontrib>Grinyó, Josep M.</creatorcontrib><creatorcontrib>Serón, Daniel</creatorcontrib><title>Resistive index and chronic allograft nephropathy evaluated in protocol biopsies as predictors of graft outcome</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol. Dial. Transplant</addtitle><description>Introduction. The presence of chronic allograft nephropathy (CAN) in protocol biopsies is negatively associated with graft survival. Although recent studies have indicated that the resistive index (RI) is a predictor of graft failure, it does not correlate with CAN in stable grafts. We therefore studied the relationship between RI and CAN and examined the predictive value of both parameters on graft outcome. Methods. Included were patients transplanted between 1997 and 2002 and who had protocol biopsies and RI determinations. Renal lesions were blindly evaluated according to Banff 97 criteria. Mean glomerular volume, cortical interstitial volume fraction and intimal arterial volume fraction were estimated using a point counting technique. RI was determined before biopsy in at least two different renal locations. The outcome variable was defined as graft failure or a 30% serum creatinine increase between protocol biopsy and last follow-up. Results. Eighty-seven patients were included. RI correlated with recipient age (R = 0.52, P<0.0001), diastolic blood pressure (R = −0.36, P = 0.0006), pulse pressure index (R = 0.27, P = 0.009) and g-score for histological glomerulitis (ρ = 0.30, P = 0.0054), but there were no correlations between RI and chronic Banff scores or any morphometric parameter. The presence of CAN (relative risk, 3.5; 95% confidence interval 1.2–10.2; P = 0.02) but not RI was associated with the outcome variable. Conclusion. RI was associated with surrogate measures of vascular compliance such as recipient age and pulse pressure index but not with chronic allograft damage, even when it was evaluated by histomorphometry. Our results indicate that histology may be superior to RI in predicting graft function deterioration, at least in patients with stable renal function.</description><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Associated diseases and complications</subject><subject>Biological and medical sciences</subject><subject>Biopsy, Needle</subject><subject>chronic allograft nephropathy</subject><subject>Chronic Disease</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Emergency and intensive care: renal failure. Dialysis management</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerulonephritis - etiology</subject><subject>Glomerulonephritis - pathology</subject><subject>Graft Rejection - complications</subject><subject>Graft Rejection - pathology</subject><subject>Graft Survival</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Kidney Glomerulus - pathology</subject><subject>Kidney Transplantation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>protocol biopsies</subject><subject>renal transplantion</subject><subject>resistive index</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Transplantation, Homologous</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkV9rFTEQxYMo9lp98QNIEPRBWJs_u8nuoxTrFSuiKBZfwmwy26bu3axJtrTf3lz2YsGnwJnfnMzMIeQ5Z2856-TJ5PLJ5eBZzR-QDa8Vq4Rsm4dkU4q8Yg3rjsiTlK4ZY53Q-jE54oppzWuxIeEbJp-yv0HqJ4e3FCZH7VUMk7cUxjFcRhgynXAu2gz56o7iDYwLZHSlg84x5GDDSHsf5uQxUUhFROdtDjHRMNDVISzZhh0-JY8GGBM-O7zH5MfZ---n2-r8y4ePp-_OKytblivkAyhE7BoJDWrUvXK9LQLHTkmUXFomO9Fj7VrV1wpE05eNnEWJLeu1PCavV98y4J8FUzY7nyyOI0wYlmRUq1opGlXAl_-B12GJU5nNCN7yumm7PfRmhWwMKUUczBz9DuKd4czsMzAlA7NmUOAXB8el36G7Rw9HL8CrAwDJwjhEmKxP95wWSuh6_2u1ciUgvP1Xh_jbKC11Y7YXv8ynM_3z4uvnzmzlX21oofQ</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>Vallejos, Augusto</creator><creator>Alperovich, Gabriela</creator><creator>Moreso, Francesc</creator><creator>Cañas, Concepcion</creator><creator>de Lama, M. Eugenia</creator><creator>Gomà, Montserrat</creator><creator>Fulladosa, Xavier</creator><creator>Carrera, Marta</creator><creator>Hueso, Miguel</creator><creator>Grinyó, Josep M.</creator><creator>Serón, Daniel</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20051101</creationdate><title>Resistive index and chronic allograft nephropathy evaluated in protocol biopsies as predictors of graft outcome</title><author>Vallejos, Augusto ; Alperovich, Gabriela ; Moreso, Francesc ; Cañas, Concepcion ; de Lama, M. Eugenia ; Gomà, Montserrat ; Fulladosa, Xavier ; Carrera, Marta ; Hueso, Miguel ; Grinyó, Josep M. ; Serón, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c380t-e1fa6eee953a5e7e7b6dbceee1e963e313c0392be4d86b46a25b771dce3e80b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Associated diseases and complications</topic><topic>Biological and medical sciences</topic><topic>Biopsy, Needle</topic><topic>chronic allograft nephropathy</topic><topic>Chronic Disease</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Emergency and intensive care: renal failure. Dialysis management</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerulonephritis - etiology</topic><topic>Glomerulonephritis - pathology</topic><topic>Graft Rejection - complications</topic><topic>Graft Rejection - pathology</topic><topic>Graft Survival</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Kidney Glomerulus - pathology</topic><topic>Kidney Transplantation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>protocol biopsies</topic><topic>renal transplantion</topic><topic>resistive index</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Transplantation, Homologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vallejos, Augusto</creatorcontrib><creatorcontrib>Alperovich, Gabriela</creatorcontrib><creatorcontrib>Moreso, Francesc</creatorcontrib><creatorcontrib>Cañas, Concepcion</creatorcontrib><creatorcontrib>de Lama, M. Eugenia</creatorcontrib><creatorcontrib>Gomà, Montserrat</creatorcontrib><creatorcontrib>Fulladosa, Xavier</creatorcontrib><creatorcontrib>Carrera, Marta</creatorcontrib><creatorcontrib>Hueso, Miguel</creatorcontrib><creatorcontrib>Grinyó, Josep M.</creatorcontrib><creatorcontrib>Serón, Daniel</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vallejos, Augusto</au><au>Alperovich, Gabriela</au><au>Moreso, Francesc</au><au>Cañas, Concepcion</au><au>de Lama, M. Eugenia</au><au>Gomà, Montserrat</au><au>Fulladosa, Xavier</au><au>Carrera, Marta</au><au>Hueso, Miguel</au><au>Grinyó, Josep M.</au><au>Serón, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Resistive index and chronic allograft nephropathy evaluated in protocol biopsies as predictors of graft outcome</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol. Dial. Transplant</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>20</volume><issue>11</issue><spage>2511</spage><epage>2516</epage><pages>2511-2516</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><coden>NDTREA</coden><abstract>Introduction. The presence of chronic allograft nephropathy (CAN) in protocol biopsies is negatively associated with graft survival. Although recent studies have indicated that the resistive index (RI) is a predictor of graft failure, it does not correlate with CAN in stable grafts. We therefore studied the relationship between RI and CAN and examined the predictive value of both parameters on graft outcome. Methods. Included were patients transplanted between 1997 and 2002 and who had protocol biopsies and RI determinations. Renal lesions were blindly evaluated according to Banff 97 criteria. Mean glomerular volume, cortical interstitial volume fraction and intimal arterial volume fraction were estimated using a point counting technique. RI was determined before biopsy in at least two different renal locations. The outcome variable was defined as graft failure or a 30% serum creatinine increase between protocol biopsy and last follow-up. Results. Eighty-seven patients were included. RI correlated with recipient age (R = 0.52, P<0.0001), diastolic blood pressure (R = −0.36, P = 0.0006), pulse pressure index (R = 0.27, P = 0.009) and g-score for histological glomerulitis (ρ = 0.30, P = 0.0054), but there were no correlations between RI and chronic Banff scores or any morphometric parameter. The presence of CAN (relative risk, 3.5; 95% confidence interval 1.2–10.2; P = 0.02) but not RI was associated with the outcome variable. Conclusion. RI was associated with surrogate measures of vascular compliance such as recipient age and pulse pressure index but not with chronic allograft damage, even when it was evaluated by histomorphometry. Our results indicate that histology may be superior to RI in predicting graft function deterioration, at least in patients with stable renal function.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>16077142</pmid><doi>10.1093/ndt/gfi041</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Associated diseases and complications Biological and medical sciences Biopsy, Needle chronic allograft nephropathy Chronic Disease Diabetes. Impaired glucose tolerance Emergency and intensive care: renal failure. Dialysis management Endocrine pancreas. Apud cells (diseases) Endocrinopathies Female Follow-Up Studies Glomerulonephritis - etiology Glomerulonephritis - pathology Graft Rejection - complications Graft Rejection - pathology Graft Survival Humans Intensive care medicine Kidney Failure, Chronic - therapy Kidney Glomerulus - pathology Kidney Transplantation Male Medical sciences Middle Aged Prognosis protocol biopsies renal transplantion resistive index Retrospective Studies Risk Factors Severity of Illness Index Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Transplantation, Homologous |
| title | Resistive index and chronic allograft nephropathy evaluated in protocol biopsies as predictors of graft outcome |
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