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RELATIONSHIP BETWEEN HISTOLOGICAL LESIONS OBSERVED IN PROTOCOL BIOPSIES AND ARTERIAL RESISTIVE INDEX

2004; Wolters Kluwer; Volume: 78; Linguagem: Inglês

10.1097/00007890-200407271-00829

1534-6080

Alfonso Vallejos, Daniel Serón, Francesc Moreso, Gabriela Alperovich, Carlos Mario Duque Cañas, Meritxell Ibernón, Joao A. Lopes, Manuel Vázquez‐Carrera, E. Lamas, Xavier Fulladosa, Miguel Hueso, Josep M. Grinyó,

Transplantation: Methods and Outcomes

P334 Aims: The renal allograft resistive index (RI) is associated with graft survival. We studied the relationship between RI and histological damage in protocol biopsies evaluated with a morphometric technique. Methods: Patients transplanted between 1997 and 2002 in whom the RI was available at the time of a 6 month protocol biopsy were considered. Renal lesions were blindly evaluated according to Banff criteria. Cortical interstitial volume fraction (Vvinterstitium/cortex) and intimal arterial volume fraction (Vvintima/artery) were estimated with a point counting technique. RI was determined before biopsy in at least 2 diferent renal locations. Results: Eighty seven patients were included, 58 received cyclosporine (CsA), 22 tacrolimus (TAC) and 7 were treated without anti-calcineurin agents. RI positively correlated with recipient age (R=0.52, p<0.0001) and g-score (Rho=0.30, p=0.0054) in protocol biopsy but negatively with diastolic blood pressure (R=0.36, p=0.0006). In the multivariate analysis the 3 variables were independently associated with RI (R=0.62, p<0.0001). There was no correlation between RI and any of the Banff scores and Vvinterstitium/cortex or Vvintima/artery. Despite the RI index was not different in patients treated with CsA, TAC or without anticalcineurin agents (0.70 ± 0.08, 0.71 ± 0.07 and 0.74 ± 0.11, respectively, p=ns), we observed a negative correlation between CsA whole blood levels and RI (R=0.27, p=0.04). Conclusions: The only histological lesion associated with an increased RI-score is the degree of glomerulitis. Tubular, interstitial or vascular lesions even when measured by means of a morphometric technique are not associated with RI. Thus, RI seems an inadequate tool to measure renal structural damage.