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Kidney Week

Abstract: FR-PO1134

Renal Graft Resistivity Index Utility in Cardiovascular Risk (CVR) Evaluation in Long-Term Kidney Transplant Recipients (KTR)

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Cigarran, Secundino, Eoxi Lugo Cervo Monforte, Burela, Spain
  • Azcarate, Naiara N., Eoxi Lugo Cervo Monforte, Burela, Spain
  • Gonzalez tabares, Lourdes, Eoxi Lugo Cervo Monforte, Burela, Spain
  • Sanjurjo amado, Ana maria, Eoxi Lugo Cervo Monforte, Burela, Spain
  • Menendez, Nicolas, Hospital da Costa, Burela, Spain
  • Calvino, Jesus, Eoxi Lugo Cervo Monforte, Burela, Spain
Background

Intra-renal graft resistivity index (RI) is an echographic measure widely used as early dysfunction marker in renal transplant (RTs). Associated factors with this index as a prognostic,outcome and patient survival are controversial.Our aim is to analyse the relationship between the RI with renal outcomes, clinical variables and cardiovascular risk (CV).

Methods

This observational study enrolled 220 stable RTs were (134 M & 86 W; Mean age 56±13.1 yo, 34% DM, 15% previous CV events),CKD stages 1-4 & more than 12 months after transplantation.Immunosuppression (IS) included anticalcineurin/mTOR with Mycophenolate Mofetil, besides steroid therapy.Variables studied: Diabetes Mellitus (DM), CV diseases history, ankle-brachial index, 24h-ABPM, anthropometric & nutritional measurements (including handgrip); as well as biochemistry parameters: hemoglobin, albumin, transferrin, creatinine, GFR estimated by CKD-EPI formula, urinary albumin/creatinine ratio (UACR), calcium, phosphorus, PTHi, vitamin D & C reactive protein.Cardiovascular risk was assessed by REGICOR equation. RI was measured by Echo-Doppler US following the standard of care technique being RI ≥0.8 as pathologic

Results

28% showed a pathologic RI.The univariable analysis showed a significant correlation IR with age (r=0.40, p<0.01) Higher in diabetic population (0.81±0.09 vs 0.73±0.10) without influenced by IS treatment. A significative negative correlation was evidenced with diastolic arterial pressure, as well as daytime (r=-0.35) as nocturnal (r=-0.23).A positive significant with a number of antihypertensive drugs (r=0.23). Also, GFR-EPI (r= -0.27) and UACR (r= 0.21) were significant as well.
Bone mineral markers PTHi (r=0.18) & P (r=0.28) were positively related to RI, meanwhile Hb (r=-0.22), albumin (r=-0.16), transferrin (r=-0.15) and dynamometry (r=-0.21) shown negative correlation. Ankle-brachial index (ABI) and REGICOR equation (r=0.18) showed also significance. Multivariable adjustments, only age and DM hold a significant relationship with RI

Conclusion

Although RI is related to functional graft factors, factors depending on RTs as age and diabetic status appear more relevant. RI may express the subclinical atheromatosis status, related to CV risk in RTs, that with the renal function itself.