Khoury G A, Irving J D, Farrington K, Varghese Z, Persaud J W, Sweny P, Moorhead J F, Fernando O N
Br Med J (Clin Res Ed). 1983 Mar 26;286(6370):1003-6. doi: 10.1136/bmj.286.6370.1003.
Sixty-five renal transplant recipients underwent digital vascular imaging of the graft and simultaneous selective venous sampling for plasma renin activity. Renal artery stenosis was found in seven patients but did not appear to be functionally important. Diffuse intrarenal arterial attenuation was found in seven patients and was associated with impaired graft function and perfusion; it may indicate chronic rejection. Lower pole hypoperfusion was found in nine patients without impaired graft function or perfusion; its clinical relevance is uncertain. Aneurysmal dilatation of the main renal artery was found in two patients. Severe hypertension was common in patients with these three major abnormalities, but a causal association between the abnormality and hypertension could rarely be inferred. It may be the abnormalities on digital vascular imaging, especially diffuse intrarenal arterial attenuation and lower pole hypoperfusion, are secondary to severe hypertension. Digital vascular imaging with simultaneous selective venous sampling for plasma renin activity is useful in evaluating the vascular anatomy of the grafted kidney and in assessing any abnormality found. The combined procedure was well tolerated by all patients with no complications and no incidence of acute tubular dysfunction or proteinuria after the investigation.
65例肾移植受者接受了移植肾的数字血管成像检查，并同时进行选择性静脉采血以检测血浆肾素活性。7例患者发现肾动脉狭窄，但似乎在功能上并不重要。7例患者发现弥漫性肾内动脉衰减，这与移植肾功能和灌注受损有关；这可能提示慢性排斥反应。9例患者发现下极灌注不足，但移植肾功能和灌注未受损；其临床意义尚不确定。2例患者发现肾主动脉瘤样扩张。这三种主要异常的患者中重度高血压很常见，但很少能推断出异常与高血压之间存在因果关系。可能数字血管成像上的异常，尤其是弥漫性肾内动脉衰减和下极灌注不足，是重度高血压的继发表现。数字血管成像结合同时进行选择性静脉采血以检测血浆肾素活性，有助于评估移植肾的血管解剖结构并评估所发现的任何异常。所有患者对联合检查耐受性良好，检查后无并发症，也无急性肾小管功能障碍或蛋白尿发生。
