Buturovic-Ponikvar J, Cerne S, Arnol M, Kandus A, Ponikvar R, Bren A
Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia.
Transplant Proc. 2010 Dec;42(10):4026-9. doi: 10.1016/j.transproceed.2010.09.053.
The aim of this study was to assess the association of various ultrasonography (US) and Doppler parameters of kidney graft as measured at 1 month posttransplant with 1-year graft function.
The study cohort included 125 adult recipients of deceased donor kidney transplantations between January 2006 and February 2009. All patients underwent an US-Doppler examination performed by a trained nephrologist at 1 month posttransplant using an Acuson-Siemens Sequoia 512. Graft length and intrarenal Doppler indices were measured at the midsegmental artery level. Relative graft size was calculated by dividing graft length with body mass index. Graft function was assessed at 1 year by estimated glomerular filtration rate (eGFR) using the 4-variable Modification of Diet in Real Disease study equation. Linear and logistic regression analyses were used to assess the relationship between US-Doppler parameters and eGFR.
Univariate linear regression showed a significant correlation between eGFR at 1 year and graft length at 1 month (P = .009), relative graft length <0.50 cm per kg/m(2) (P = .004), resistance index >0.75 (P = .031), and end-diastolic velocity <9 cm/sec (P = .006). Logistic regression analyses showed that eGFR <60 mL/min/1.73 m(2) at 1 year was significantly associated with graft length <12 cm at 1 month (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.16-4.92; P = .017), relative graft length <0.5 cm per kg/m(2) (OR, 2.54; 95% CI, 1.20-5.35; P = .014), resistance index >0.75 (OR, 2.86; 95% CI, 1.30-6.29; P = .009), and end-diastolic velocity <9 cm/sec (OR, 2.37; 95% CI, 1.01-5.56; P = .047).
In this retrospective analysis, kidney transplant recipients with greater graft length at 1 month, specifically when standardized to body size, showed better graft function at 1 year posttransplantation. Higher intrarenal diastolic blood flow and lower resistance index at 1 month were also predictive of better graft function at 1 year.
本研究旨在评估肾移植术后1个月时所测的各种肾脏移植超声检查（US）和多普勒参数与1年移植肾功能之间的关联。
研究队列包括2006年1月至2009年2月间125例接受已故供体肾移植的成年受者。所有患者在移植后1个月由训练有素的肾脏病学家使用Acuson - 西门子Sequoia 512进行US - 多普勒检查。在肾段动脉中段水平测量移植肾长度和肾内多普勒指数。通过将移植肾长度除以体重指数计算相对移植肾大小。使用4变量的“真实疾病饮食改良研究”方程通过估计肾小球滤过率（eGFR）在1年时评估移植肾功能。采用线性和逻辑回归分析评估US - 多普勒参数与eGFR之间的关系。
单变量线性回归显示1年时的eGFR与1个月时的移植肾长度（P = 0.009）、相对移植肾长度<0.50 cm/kg/m²（P = 0.004）、阻力指数>0.75（P = 0.031）以及舒张末期速度<9 cm/秒（P = 0.006）之间存在显著相关性。逻辑回归分析显示，1年时eGFR<60 mL/min/1.73 m²与1个月时移植肾长度<12 cm（优势比[OR]，2.4；95%置信区间[CI]，1.16 - 4.92；P = 0.017）、相对移植肾长度<0.5 cm/kg/m²（OR，2.54；95% CI，1.20 - 5.35；P = 0.014）、阻力指数>0.75（OR，2.86；95% CI，1.30 - 6.29；P = 0.009）以及舒张末期速度<9 cm/秒（OR，2.37；95% CI，1.01 - 5.56；P = 0.047）显著相关。
在这项回顾性分析中，肾移植受者在1个月时移植肾长度更大，特别是在根据体型进行标准化后，在移植后1年显示出更好的移植肾功能。1个月时较高的肾内舒张期血流和较低的阻力指数也预示着1年时更好的移植肾功能。
