Vascular Practice Wil and University Zurich, Zurich, Switzerland.
Vascular Center, Cantonal Hospital Baden, Baden, Switzerland.
In Vivo. 2021 Nov-Dec;35(6):3369-3375. doi: 10.21873/invivo.12635.
BACKGROUND/AIM: Patients after kidney transplants are at risk of cardiovascular morbidity. An elevated resistance index (RI) is associated with renal graft failure, while a decreased RI can be due to a renal artery stenosis. The RI can also be measured in the carotid artery. Whether a correlation between intrarenal RI after kidney transplant in adult patients and the RI of the internal carotid artery exists is still unclear.
In this prospective cross-sectional study, RI of kidney transplants and of the internal carotid artery were measured with duplex sonography. Carotid intima-media thickness as well as the Framingham risk score and the Augmentation index, all known markers of atherosclerosis, were assessed. Correlations between the RI in Carotid artery and the RI of the kidney transplant were based on Spearmen test with the level of significance set at p<0.05.
Ninety-eight consecutive patients [60% male, mean age of 48.7 (±15.6)] were included. The mean interval after transplantation was 27.5 (±8.5) months and mean serum creatinine was 308 (±220.3) mmol/ml The RI of the internal carotid artery and the renal transplant were significantly correlated (p<0.05). A correlation between the RIs and the Augmentation Index was found.
The RI of the kidney transplant is correlated with the RI of the carotid artery and to markers of general atherosclerosis. This observation may be helpful to identify patients after kidney transplant with higher risk for cardiovascular events and gain indirect information on transplant renal artery stenosis.
背景/目的：肾移植后的患者存在心血管发病率的风险。阻力指数（RI）升高与肾移植失败相关，而 RI 降低可能是由于肾动脉狭窄。颈动脉的 RI 也可以进行测量。成人肾移植后肾内 RI 与颈内动脉 RI 之间是否存在相关性尚不清楚。
在这项前瞻性横断面研究中，使用双功能超声测量肾移植和颈内动脉的 RI。评估颈动脉内膜中层厚度以及已知的动脉粥样硬化标志物——弗雷明汉风险评分和增强指数。基于 Spearman 检验评估颈动脉 RI 和肾移植 RI 之间的相关性，置信水平设为 p<0.05。
共纳入 98 例连续患者[60%为男性，平均年龄 48.7（±15.6）岁]。平均移植后间隔为 27.5（±8.5）个月，平均血清肌酐为 308（±220.3）mmol/ml。颈内动脉和肾移植的 RI 显著相关（p<0.05）。RI 与增强指数之间存在相关性。
肾移植的 RI 与颈动脉的 RI 以及一般动脉粥样硬化的标志物相关。这一观察结果可能有助于识别肾移植后心血管事件风险较高的患者，并获得有关移植肾动脉狭窄的间接信息。
