Impact on renal resistive index of diabetes in renal transplant donors and recipients: A retrospective analysis of 1827 kidney transplant recipients.
Adult
Aged
Algorithms
Blood Pressure
/ physiology
Creatinine
/ blood
Delayed Graft Function
/ physiopathology
Diabetes Mellitus
/ physiopathology
Female
France
/ epidemiology
Glomerular Filtration Rate
/ physiology
Humans
Kidney
/ blood supply
Kidney Transplantation
/ adverse effects
Male
Middle Aged
Proteinuria
/ urine
Renal Dialysis
/ statistics & numerical data
Retrospective Studies
Tissue Donors
/ statistics & numerical data
Transplant Recipients
/ statistics & numerical data
Ultrasonography, Doppler
/ methods
Vascular Resistance
/ physiology
diabetes mellitus
kidney transplant
renal resistive index
ultrasonography
vascular resistance
Journal
Journal of clinical hypertension (Greenwich, Conn.)
ISSN: 1751-7176
Titre abrégé: J Clin Hypertens (Greenwich)
Pays: United States
ID NLM: 100888554
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
21
08
2018
revised:
19
10
2018
accepted:
30
10
2018
pubmed:
16
2
2019
medline:
25
6
2020
entrez:
16
2
2019
Statut:
ppublish
Résumé
High renal resistive index (RI) is observed in diabetes and is associated with poor patient survival, but whether it is primarily due to renal vascular resistance or systemic vascular alterations is unclear. The respective impact of kidney transplant from diabetic donors or to diabetic recipients on RI would shed some light on this issue. The objective of the study was to analyze the impact of donor and recipient diabetes on RI in order to understand the respective impact of the kidney and the vascular environment. The authors conducted a retrospective study in 1827 renal transplant recipients who received a kidney between 1985 and 2017, and had Doppler measurements at 3 months after transplant. Donor and recipient characteristics at the time of transplant and at 3 months were reviewed. Both donor diabetes and recipient diabetes were associated with RI in univariate analysis, but only recipient diabetes remained significantly associated in stepwise multivariate analyses (effect estimate on RI: +0.03 ± 0.005, P < 0.001). These findings were confirmed when RI was expressed as a binary variable using a cutoff of 0.75 (OR = 2.50 [1.77, 3.54], P < 0.001). Other determinants of RI were recipient characteristics (age, sex, systolic and diastolic blood pressure, and duration of dialysis). Donor characteristics were not associated with RI. Our results suggest that high RI observed in diabetic recipients shortly after transplant is primarily due to the new vascular environment, rather than to characteristics of the transplanted kidney. Therefore, RI reflects systemic rather than intra-renal changes.
Identifiants
pubmed: 30767377
doi: 10.1111/jch.13492
pmc: PMC8030490
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
382-389Informations de copyright
©2019 Wiley Periodicals, Inc.
Références
Am J Transplant. 2006 Nov;6(11):2721-4
pubmed: 17049059
Transplant Proc. 2009 Mar;41(2):645-7
pubmed: 19328944
Am J Hypertens. 2013 Jun;26(6):754-61
pubmed: 23449605
Transpl Int. 2012 Apr;25(4):464-70
pubmed: 22364312
AJR Am J Roentgenol. 2003 Apr;180(4):885-92
pubmed: 12646425
J Am Soc Nephrol. 2007 Jun;18(6):1942-52
pubmed: 17460143
Hypertension. 2014 Nov;64(5):915-7
pubmed: 25156171
Diabetologia. 1998 Jan;41(1):121-4
pubmed: 9498641
J Urol. 1999 Jan;161(1):28-32
pubmed: 10037360
J Clin Hypertens (Greenwich). 2019 Mar;21(3):382-389
pubmed: 30767377
N Engl J Med. 2013 Nov 7;369(19):1797-806
pubmed: 24195547
Clin Exp Nephrol. 2015 Dec;19(6):1114-9
pubmed: 26081566
J Am Soc Nephrol. 2008 Apr;19(4):798-805
pubmed: 18235095
N Engl J Med. 2003 Jul 10;349(2):115-24
pubmed: 12853584
Nephron Clin Pract. 2010;114(3):c178-86
pubmed: 19955823
J Ultrasound Med. 2000 May;19(5):303-14
pubmed: 10811403
Nephrol Dial Transplant. 2007 Jan;22(1):163-70
pubmed: 16936334
J Hypertens. 2005 Oct;23(10):1905-11
pubmed: 16148615
Am J Transplant. 2005 Sep;5(9):2281-8
pubmed: 16095510
Hypertension. 2014 Jan;63(1):136-42
pubmed: 24126174
Radiology. 1999 Sep;212(3):732-8
pubmed: 10478240
Nephrol Dial Transplant. 1997 Jul;12(7):1376-80
pubmed: 9249772
Rev Prat. 1975 Dec 21;25(59):4671-80
pubmed: 1215793
N Engl J Med. 2001 Feb 8;344(6):410-7
pubmed: 11172177
BMC Nephrol. 2012 Oct 25;13:139
pubmed: 23098365
Crit Care. 2012 Nov 15;16(6):174
pubmed: 23171782
Nephrol Dial Transplant. 2006 Oct;21(10):2916-20
pubmed: 16891640
Nephrol Dial Transplant. 2012 Aug;27(8):3315-20
pubmed: 22290990