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Renal arterial resistance index and computerized quantification of fibrosis as a combined predictive tool in chronic allograft nephropathy
Author(s) -
Pape Lars,
Mengel Michael,
Offner Gisela,
Melter Michael,
Ehrich Jochen H. H.,
Strehlau Juergen
Publication year - 2004
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2004.00229.x
Subject(s) - medicine , chronic allograft nephropathy , transplantation , creatinine , urology , biopsy , predictive value , kidney transplantation , kidney , fibrosis , predictive value of tests , nephropathy , cardiology , endocrinology , diabetes mellitus
The renal arterial resistance index (RI) and the PicroSiriusRed stained cortical fractional interstitial fibrosis volume (VintFib) proved to be two independent methods that are reliable predictive factors of poor renal allograft outcome. No data have been published, which define the correlation between ultrasound assessment and quantitative morphologic changes. Renal biopsies were performed in 56 children according to increases in s‐creatinine >10%. VintFib was calculated by computerized image analysis. RI was determined in two segmental arteries, 1 yr after transplantation and at the time‐point of biopsy. RIs 1 yr after transplantation correlated significantly with RIs at time of biopsy (r = 0.58, p < 0.001). VintFib was higher in children with a RI = 80 than in children with a RI < 80 (mean VintFib = 9.5 ± 3.2% vs. 5.2 ± 5.1%, p = 0.004). In children with VintFib > 10%, the mean RI was 77 ± 5 compared with 69 ± 6 in patients with VintFib < 10% (p = 0.0002). The highest positive predictive value to detect the risk of decline of GFR at 2 yr after biopsy was 98% when an RI = 80% was associated with a VintFib > 10%. For VintFib > 10% or RI = 80 alone, it was 87% or 67%, respectively. The combined measurement of RI and VintFib is a reliable predictive tool for the risk of developing long‐term graft dysfunction after kidney transplantation.