World Journal of Urology

, Volume 29, Issue 4, pp 547–553

Immediate renal Doppler ultrasonography findings (<24 h) and its association with graft survival

Authors

    • Department of UrologyUniversity of Navarra Clinic
  • Jorge Rioja
    • Department of UrologyMiguel Servet Hospital
  • José Enrique Robles
    • Department of UrologyUniversity of Navarra Clinic
  • Anibal Rincón
    • Department of UrologyUniversity of Navarra Clinic
  • David Rosell
    • Department of UrologyUniversity of Navarra Clinic
  • Juan Javier Zudaire
    • Department of UrologyUniversity of Navarra Clinic
  • José María Berian
    • Department of UrologyUniversity of Navarra Clinic
  • Ignacio Pascual
    • Department of UrologyUniversity of Navarra Clinic
  • Alberto Benito
    • Radiology ServiceUniversity of Navarra Clinic
  • Pedro Errasti
    • Department of NephrologyUniversity of Navarra Clinic
Original Article

DOI: 10.1007/s00345-011-0666-3

Cite this article as:
Barba, J., Rioja, J., Robles, J.E. et al. World J Urol (2011) 29: 547. doi:10.1007/s00345-011-0666-3

Abstract

Purpose

Renal Doppler ultrasonography (DUS) is the gold-standard image test for follow-up after renal transplantation, it is potentially useful to detect renal disease and it could be related with long-term survival. We evaluate whether renal graft survival can be predicted by immediate renal Doppler ultrasonography (IRDUS), defined as ultrasonography carried out in the first 24 h post-surgery.

Materials and methods

Immediate renal DUS findings (resistance index, hydronephrosis, fluid collection, bruises, and vascularization abnormalities) and their association with graft survival were analyzed in a retrospective observational study of 343 renal allografts. Renal transplantation was done using a standard technique, and DUS was performed 24 h post-transplantation. The association of variables with graft survival was evaluated by Cox univariate and multivariate proportional hazards analysis. Kaplan–Meier survival analysis and the log-rank test were used to examine graft survival.

Results

The follow-up median was 85 months. On IRDUS, 137 patients (39.9%) had abnormal findings. The best RI cutpoint for the prediction of graft survival was 0.7; therefore, we defined two different groups: RI ≤ 0.7 (n = 247) versus RI > 0.7 (n = 96). Univariate analysis revealed that graft survival was significantly lower in patients with RI > 0.7 (P ≤ 0.001), vascularization abnormalities (P ≤ 0.001) or bruises (P = 0.026). In multivariate analysis, the only factors independently associated with graft survival were RI (odds ratio 2.4; 95% CI 1.4–4.1) and vascularization abnormalities (odds ratio 2.7; 95% CI 1.1–6.5).

Conclusions

IRDUS can be useful, besides being highly useful in the diagnosis of graft primary dysfunction in the transplanted patient also yields information that can help to predict long-term graft survival.

Keywords

Kidney transplantationGraft survivalDoppler ultrasonographyPredictive value

Abbreviations

CI

Confidence interval

DUS

Doppler ultrasonography

IRDUS

Immediate renal Doppler ultrasonography

OR

Odds ratio

RI

Resistance index

SD

Standard deviation

BMI

Body mass index

Copyright information

© Springer-Verlag 2011