Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany; Intensive Care Unit, Ghent University Hospital, Ghent University, Ghent, Belgium.
Faculty of Medicine, Ruhr-University Bochum, Bochum, Germany.
J Crit Care. 2022 Oct;71:154112. doi: 10.1016/j.jcrc.2022.154112. Epub 2022 Jul 14.
During the postoperative stay in the intensive care unit after kidney transplantation, the renal resistive index (RI) is routinely measured. An increased RI, measured months posttransplant, is associated with a higher mortality. We wanted to investigate the value of the RI immediately posttransplant in predicting both short- and long-term outcome.
We performed a retrospective single-center study. The RI was collected <48 h posttransplant in patients undergoing kidney transplantations between 2005 and 2014. Short-term outcome was evaluated by delayed graft function (DGF). The long-term endpoints were kidney function and mortality at 30 days, 1 year and 5 years.
We included 478 recipients, 91.4% of whom reached the end of the 5-year follow-up. A higher RI < 48 h posttransplant was significantly associated with DGF. This association was particularly strong in patients receiving grafts from donors after brain death and expanded criteria donors. A higher RI also correlated with mortality and death with functioning graft but not with graft failure. After adjustment for confounders, we found an association between increased RI and DGF, but not with long-term kidney function or mortality.
The RI routinely measured <48 h posttransplant is an independent predictor of short-term kidney function.
在肾移植后入住重症监护病房期间，常规测量肾脏阻力指数（RI）。移植后数月测量的 RI 升高与更高的死亡率相关。我们希望研究移植后即刻 RI 值在预测短期和长期结局方面的价值。
我们进行了一项回顾性单中心研究。在 2005 年至 2014 年间接受肾移植的患者中，<48 小时内收集 RI。通过延迟移植物功能（DGF）评估短期结局。长期终点是 30 天、1 年和 5 年时的肾功能和死亡率。
我们纳入了 478 名受者，其中 91.4%达到了 5 年随访结束。<48 小时内较高的 RI 值与 DGF 显著相关。在接受脑死亡供体和扩大标准供体供体的患者中，这种相关性尤为强烈。较高的 RI 值还与死亡率和带功能移植物的死亡相关，但与移植物衰竭无关。在调整混杂因素后，我们发现 RI 升高与 DGF 之间存在关联，但与长期肾功能或死亡率无关。
<48 小时内常规测量的 RI 是短期肾功能的独立预测因子。
