Service of Nephrology, University Hospital Valdecilla, University of Cantabria, Santander, Spain.
Nephron Clin Pract. 2010;114(3):c178-86. doi: 10.1159/000262300. Epub 2009 Nov 28.
Measurement of the vascular resistive index (RI) by Doppler ultrasonography has been proposed as a non-invasive method to evaluate renal allograft dysfunction, but there are conflicting reports about its clinical utility. The aim of our study was to analyse the donor and recipient characteristics related to RI measured at days 2 and 3 after renal transplantation and the relationship between RI and allograft outcome. RI was measured by Doppler ultrasonography in 333 patients at days 2 or 3 post-transplantation. Donor and recipient variables and allograft outcome were collected from a prospectively maintained institutional database. In patients with RI higher than 0.7, donor age, recipient age, duration of renal replacement therapy, incidence of diabetes, hypertension and atherosclerosis in the recipient, pulse pressure, initial creatinine and the incidence of delayed graft function (DGF) were higher. After multivariate analysis, the only variables that remained significant for an increased risk of higher RI were recipient age over 55 years, presence of diabetes in the recipient and DGF. Recipient age, previous diabetes mellitus and DGF are the most important determinants of transplant kidney RI in the first days after transplantation. So both the graft recipient and the graft itself, but not the donor, determine intra-renal Doppler indices.
多普勒超声测量肾移植后第 2 和第 3 天的血管阻力指数（RI）已被提议作为一种评估肾移植功能障碍的非侵入性方法，但关于其临床实用性存在相互矛盾的报道。我们的研究目的是分析与肾移植后第 2 或第 3 天测量的 RI 相关的供体和受者特征，以及 RI 与移植物结局之间的关系。在 333 例肾移植患者中，在移植后第 2 或第 3 天通过多普勒超声测量 RI。从一个前瞻性维护的机构数据库中收集供体和受者变量以及移植物结局。在 RI 高于 0.7 的患者中，供体年龄、受者年龄、肾脏替代治疗持续时间、受者糖尿病、高血压和动脉粥样硬化的发生率、脉压、初始肌酐和延迟移植物功能（DGF）的发生率较高。多变量分析后，唯一与 RI 升高风险增加相关的变量是受者年龄超过 55 岁、受者存在糖尿病和 DGF。受者年龄、既往糖尿病和 DGF 是移植后最初几天移植肾 RI 的最重要决定因素。因此，决定肾内多普勒指数的不仅是移植物受体，还有移植物本身，但不是供体。
