Bogaert S, Suchonos N, Mohan PV, Decruyenaere A, Decruyenaere P, De Waele J, Vermassen F, Van Laecke S, Peeters P, Westhoff TH, Hoste EAJ. Predictive value of the renal resistive index in the immediate postoperative period after kidney transplantation on short- and long-term graft and patient outcomes.
J Crit Care 2022;
71:154112. [PMID:
35843045 DOI:
10.1016/j.jcrc.2022.154112]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/05/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION
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.
METHODS
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.
RESULTS
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.
CONCLUSION
The RI routinely measured <48 h posttransplant is an independent predictor of short-term kidney function.
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