Guo Yimin, Yang Yujia, Luo Shu, Ren Yelei, Chen Hongyan, Yang Yanrong, Shi Shuhua, Yang Lichuan, Li Yongzhong, Zhou Jiaojiao
Department of Ultrasound Medicine, West China Hospital of Sichuan University, Chengdu, China.
Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Quant Imaging Med Surg. 2025 Mar 3;15(3):2065-2075. doi: 10.21037/qims-24-1530. Epub 2025 Feb 26.
For patients with chronic kidney disease (CKD), it is crucial to detect delayed graft function (DGF) promptly after kidney transplantation; however, the application value of ultrasound as a non-invasive monitoring method has not yet been studied. Therefore, our study compared the ultrasound results between a DGF group and a normal graft function (NGF) group to explore the application value of ultrasound-related parameters, especially renal resistive index (RI), in diagnosing DGF.
This was a single-center retrospective study. We analyzed the clinical data of patients who underwent kidney transplantation at West China Hospital of Sichuan University from 1 July 2019 to 1 April 2023, and collected all patients' demographic information, clinical test results, and ultrasound parameters on Doppler ultrasound (DUS). According to the definition of DGF, all patients were divided into either the DGF group or the NGF group.
Our study enrolled 225 patients (DGF group, n=115; NGF group, n=110), including 153 men and 72 women, with a mean age of 38.4±11.6 years. Compared with the NGF group, the body mass index (BMI), serum urea nitrogen (SUN), serum creatinine (SCr), cystatin C (Cys-C), and uric acid (UA) in the DGF group were significantly higher, and the albumin (ALB) and estimated glomerular filtration rate (eGFR) in DGF group were lower (P<0.05). The results of ultrasound parameters' comparison showed that the renal RI of the DGF patients was significantly higher compared with that of the NGF patients (P<0.05), and the renal artery RI measured ≥48 hours after kidney transplantation was higher than that measured <48 hours (P<0.05). Additionally, the area under the curve (AUC) of the RI measured ≥48 hours after kidney transplantation was generally larger, which revealed significantly better performance for DGF.
Increased RI may be a predictor to indicate the occurrence of DGF, which can help clinicians in early recognition of DGF and improve long-term graft survival.
对于慢性肾脏病（CKD）患者，肾移植后及时检测移植肾功能延迟（DGF）至关重要；然而，超声作为一种非侵入性监测方法的应用价值尚未得到研究。因此，我们的研究比较了DGF组和移植肾功能正常（NGF）组的超声检查结果，以探讨超声相关参数，尤其是肾阻力指数（RI）在诊断DGF中的应用价值。
这是一项单中心回顾性研究。我们分析了2019年7月1日至2023年4月1日在四川大学华西医院接受肾移植患者的临床资料，并收集了所有患者的人口统计学信息、临床检查结果以及多普勒超声（DUS）的超声参数。根据DGF的定义，将所有患者分为DGF组或NGF组。
我们的研究纳入了225例患者（DGF组，n = 115；NGF组，n = 110），其中男性153例，女性72例，平均年龄为38.4±11.6岁。与NGF组相比，DGF组的体重指数（BMI）、血清尿素氮（SUN）、血清肌酐（SCr）、胱抑素C（Cys-C）和尿酸（UA）显著更高，而DGF组的白蛋白（ALB）和估计肾小球滤过率（eGFR）更低（P<0.05）。超声参数比较结果显示，DGF患者的肾RI显著高于NGF患者（P<0.05），肾移植后≥48小时测量的肾动脉RI高于<48小时测量的结果（P<0.05）。此外，肾移植后≥48小时测量的RI的曲线下面积（AUC）总体上更大，这表明其对DGF的诊断性能显著更好。
RI升高可能是提示DGF发生的一个预测指标，这有助于临床医生早期识别DGF并提高移植肾长期存活。
