糖尿病和非糖尿病肾移植受者肾阻力指数的早期变化与死亡率：一项队列研究。

Early changes in renal resistive index and mortality in diabetic and nondiabetic kidney transplant recipients: a cohort study.

机构信息

Néphrologie-Immunologie Clinique, Hôpital Bretonneau, CHU Tours, Tours, France.

University of Tours, Tours, France.

出版信息

BMC Nephrol. 2021 Feb 19;22(1):62. doi: 10.1186/s12882-021-02263-8.

DOI:10.1186/s12882-021-02263-8

PMID:33607945

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7893742/

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.

摘要

背景

肾阻力指数（RI）可预测肾移植受者（RTR）的死亡率。然而，其预测价值可能因测量时间的不同而有所不同。我们分析了移植后 1 个月至 3 个月 RI 的变化及其对有功能移植物死亡（DWFG）的预测价值。

方法

我们对 1985 年至 2017 年间的 1685 例 RTR 进行了回顾性研究。评估了 RI 值从 1 个月到 3 个月的变化在糖尿病和非糖尿病 RTR 中的长期预测价值。

结果

在 1 个月和 3 个月时 RI<0.70 的 RTR 患者的最佳存活率，而在 1 个月和 3 个月时 RI≥0.70 的 RTR 患者的存活率最差（HR=3.77，[2.71-5.24]，p<0.001）。在 1 个月时 RI<0.70 而 3 个月时 RI≥0.70 时（HR=2.15 [1.29-3.60]，p=0.003）和在 1 个月时 RI≥0.70 而 3 个月时 RI<0.70 时（HR=1.90 [1.20-3.03]，p=0.006），RI 与 DWFG 的风险呈中度相关。在糖尿病 RTR 中，仅在 1 个月时 RI<0.70 而 3 个月时 RI≥0.70 时，RI 与死亡风险显著相关（HR=4.69 [1.07-20.52]，p=0.040）。RI 被视为 1 个月和 3 个月的连续变量与非糖尿病 RTR 的 DWFG 风险显著相关，但与糖尿病 RTR 无关。