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International Urology and Nephrology

, Volume 46, Issue 7, pp 1435–1440 | Cite as

Transient elastography: a new noninvasive diagnostic tool for assessment of chronic allograft nephropathy

  • V. Lukenda
  • I. MikolasevicEmail author
  • S. Racki
  • I. Jelic
  • D. Stimac
  • L. Orlic
Nephrology - Original Paper

Abstract

Purpose

Chronic allograft nephropathy (CAN) is the most common cause of kidney allograft failure. Protocol biopsies remain the “gold standard” in CAN recognition. However, renal allograft biopsies have numerous limitations. It is an invasive procedure connected with risk of complications, patient discomfort, and sampling errors. The aim of our study was to investigate the usefulness of transient elastography (TE) for the assessment of kidney allograft fibrosis in renal transplant recipients (RTRs).

Methods

In this cross-sectional study, we involved 52 RTRs. Renal allograft stiffness was used to assess its fibrosis by using transient elastography (Fibroscan®, Echosense, Paris, France). In 23 patients with a deterioration of graft function, percutaneous renal allograft biopsy was performed closely around the time of TE.

Results

We have found that the renal allograft stiffness was highly negatively correlated with estimated glomerular filtration rate (eGFR) (r = −0.640; p < 0.0001). However, renal allograft stiffness showed a statistically significant difference between patients who had an eGFR > 50 ml/min per 1.73 m2 and patients with eGFR < 50 ml/min per 1.73 m2 (28 ± 2.7 vs. 33.9 ± 5.5 kPa; p = 0.0003). Also, there was a highly positive correlation between renal allograft stiffness and extent of interstitial fibrosis on renal biopsy (r = 0.727; p = 0.0001).

Conclusion

According to our results, parenchymal stiffness obtained by TE reflects interstitial fibrosis. Therefore, TE provides the opportunity for noninvasive screening of CAN.

Keywords

Chronic allograft nephropathy Protocol biopsies Transient elastography Renal transplant recipients 

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • V. Lukenda
    • 1
  • I. Mikolasevic
    • 2
    Email author
  • S. Racki
    • 2
  • I. Jelic
    • 2
  • D. Stimac
    • 3
  • L. Orlic
    • 2
  1. 1.Department of Internal MedicineGeneral Hospital “Dr. Josip Bencevic”Slavonski BrodCroatia
  2. 2.Department of Nephrology and Dialysis, Division of Internal MedicineUniversity Hospital Center RijekaRijekaCroatia
  3. 3.Department of Gastroenterology, Division of Internal MedicineUniversity Hospital RijekaRijekaCroatia

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