Risk factors of transplant renal artery stenosis in kidney transplant recipients
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/213530 |
Resumo: | Background: Transplant Renal Artery Stenosis (TRAS) is a recognized vascular complication after kidney transplantation. The overall risk predictors of TRAS are poorly understood. Methods: Retrospective analysis of patients with suspected TRAS (Doppler ultrasound PSV > 200 cm/s) who underwent angiographic study in a single center between 2007 and 2014. All patients with stenosis > 50% were considered with TRAS. Stenosis restricted in the body of the artery was also analyzed in a subgroup. Results: 274 patients were submitted to a renal angiography and 166 confirmed TRAS. TRAS group featured an older population (46.3 ± 11.0 vs. 40.9 ±14.2 years; p = 0.001), more frequent hypertensive nephropathy (30.1% vs. 15.7%; p = 0.01), higher incidence of Delayed Graft Function (DGF) (52.0% vs. 25.6%; p < 0.001) and longer Cold Ischemia Time (CIT) (21.5 ± 10.6 vs. 15.7 ± 12.9h; p < 0.001). In multivariable analyses, DGF (OR = 3.31; 95% CI 1.78‒6.30; p < 0.0001) was independent risk factors for TRAS. DM and CIT showed a tendency towards TRAS. The compound discriminatory capacity of the multivariable model (AUC = 0.775; 95% CI 0.718‒0.831) is significantly higher than systolic blood pressure and creatinine alone (AUC = 0.62; 95% CI 0.558–0.661). In body artery stenosis subgroup, DGF (OR = 1.86; 95% CI 1.04‒3.36; p = 0.03) and Diabetes Mellitus (DM) (OR = 2.44; 95% CI 1.31‒4.60; p = 0.005) were independent risk factors for TRAS. Conclusion: In our transplant population, DGF increased more than 3-fold the risk of TRAS. In the subgroup analysis, both DGF and DM increases the risk of body artery stenosis. The addition of other factors to hypertension and renal dysfunction may increase diagnostic accuracy. TRAS Trial registred: clinicaltrials.gov (n° NCT04225338). |
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Clinics |
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Risk factors of transplant renal artery stenosis in kidney transplant recipientsTransplant renal artery stenosisRenal angiographyRisk factors for TRASKidney transplantBackground: Transplant Renal Artery Stenosis (TRAS) is a recognized vascular complication after kidney transplantation. The overall risk predictors of TRAS are poorly understood. Methods: Retrospective analysis of patients with suspected TRAS (Doppler ultrasound PSV > 200 cm/s) who underwent angiographic study in a single center between 2007 and 2014. All patients with stenosis > 50% were considered with TRAS. Stenosis restricted in the body of the artery was also analyzed in a subgroup. Results: 274 patients were submitted to a renal angiography and 166 confirmed TRAS. TRAS group featured an older population (46.3 ± 11.0 vs. 40.9 ±14.2 years; p = 0.001), more frequent hypertensive nephropathy (30.1% vs. 15.7%; p = 0.01), higher incidence of Delayed Graft Function (DGF) (52.0% vs. 25.6%; p < 0.001) and longer Cold Ischemia Time (CIT) (21.5 ± 10.6 vs. 15.7 ± 12.9h; p < 0.001). In multivariable analyses, DGF (OR = 3.31; 95% CI 1.78‒6.30; p < 0.0001) was independent risk factors for TRAS. DM and CIT showed a tendency towards TRAS. The compound discriminatory capacity of the multivariable model (AUC = 0.775; 95% CI 0.718‒0.831) is significantly higher than systolic blood pressure and creatinine alone (AUC = 0.62; 95% CI 0.558–0.661). In body artery stenosis subgroup, DGF (OR = 1.86; 95% CI 1.04‒3.36; p = 0.03) and Diabetes Mellitus (DM) (OR = 2.44; 95% CI 1.31‒4.60; p = 0.005) were independent risk factors for TRAS. Conclusion: In our transplant population, DGF increased more than 3-fold the risk of TRAS. In the subgroup analysis, both DGF and DM increases the risk of body artery stenosis. The addition of other factors to hypertension and renal dysfunction may increase diagnostic accuracy. TRAS Trial registred: clinicaltrials.gov (n° NCT04225338).Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2022-08-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/21353010.1016/j.clinsp.2022.100087Clinics; v. 77 (2022); 100087Clinics; Vol. 77 (2022); 100087Clinics; Vol. 77 (2022); 1000871980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/213530/195621Copyright (c) 2023 Clinicsinfo:eu-repo/semantics/openAccessKanhouche, GabrielSantos, Gustavo Rocha FeitosaOrellana, Henry CamposGalhardo, AttilioFaccinetto, Ana Carolina BusoBarteczko, Manoela Linhares MachadoCarvalho, Luiz Sérgio F. deTaddeo, Julia BernardiForesto, Renato DemarchiMoises, Valdir AmbrósioTedesco-Silva, HelioPestana, José Medina Barbosa, Adriano Henrique Pereira2023-06-24T01:04:58Zoai:revistas.usp.br:article/213530Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2023-06-24T01:04:58Clinics - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Risk factors of transplant renal artery stenosis in kidney transplant recipients |
title |
Risk factors of transplant renal artery stenosis in kidney transplant recipients |
spellingShingle |
Risk factors of transplant renal artery stenosis in kidney transplant recipients Kanhouche, Gabriel Transplant renal artery stenosis Renal angiography Risk factors for TRAS Kidney transplant |
title_short |
Risk factors of transplant renal artery stenosis in kidney transplant recipients |
title_full |
Risk factors of transplant renal artery stenosis in kidney transplant recipients |
title_fullStr |
Risk factors of transplant renal artery stenosis in kidney transplant recipients |
title_full_unstemmed |
Risk factors of transplant renal artery stenosis in kidney transplant recipients |
title_sort |
Risk factors of transplant renal artery stenosis in kidney transplant recipients |
author |
Kanhouche, Gabriel |
author_facet |
Kanhouche, Gabriel Santos, Gustavo Rocha Feitosa Orellana, Henry Campos Galhardo, Attilio Faccinetto, Ana Carolina Buso Barteczko, Manoela Linhares Machado Carvalho, Luiz Sérgio F. de Taddeo, Julia Bernardi Foresto, Renato Demarchi Moises, Valdir Ambrósio Tedesco-Silva, Helio Pestana, José Medina Barbosa, Adriano Henrique Pereira |
author_role |
author |
author2 |
Santos, Gustavo Rocha Feitosa Orellana, Henry Campos Galhardo, Attilio Faccinetto, Ana Carolina Buso Barteczko, Manoela Linhares Machado Carvalho, Luiz Sérgio F. de Taddeo, Julia Bernardi Foresto, Renato Demarchi Moises, Valdir Ambrósio Tedesco-Silva, Helio Pestana, José Medina Barbosa, Adriano Henrique Pereira |
author2_role |
author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Kanhouche, Gabriel Santos, Gustavo Rocha Feitosa Orellana, Henry Campos Galhardo, Attilio Faccinetto, Ana Carolina Buso Barteczko, Manoela Linhares Machado Carvalho, Luiz Sérgio F. de Taddeo, Julia Bernardi Foresto, Renato Demarchi Moises, Valdir Ambrósio Tedesco-Silva, Helio Pestana, José Medina Barbosa, Adriano Henrique Pereira |
dc.subject.por.fl_str_mv |
Transplant renal artery stenosis Renal angiography Risk factors for TRAS Kidney transplant |
topic |
Transplant renal artery stenosis Renal angiography Risk factors for TRAS Kidney transplant |
description |
Background: Transplant Renal Artery Stenosis (TRAS) is a recognized vascular complication after kidney transplantation. The overall risk predictors of TRAS are poorly understood. Methods: Retrospective analysis of patients with suspected TRAS (Doppler ultrasound PSV > 200 cm/s) who underwent angiographic study in a single center between 2007 and 2014. All patients with stenosis > 50% were considered with TRAS. Stenosis restricted in the body of the artery was also analyzed in a subgroup. Results: 274 patients were submitted to a renal angiography and 166 confirmed TRAS. TRAS group featured an older population (46.3 ± 11.0 vs. 40.9 ±14.2 years; p = 0.001), more frequent hypertensive nephropathy (30.1% vs. 15.7%; p = 0.01), higher incidence of Delayed Graft Function (DGF) (52.0% vs. 25.6%; p < 0.001) and longer Cold Ischemia Time (CIT) (21.5 ± 10.6 vs. 15.7 ± 12.9h; p < 0.001). In multivariable analyses, DGF (OR = 3.31; 95% CI 1.78‒6.30; p < 0.0001) was independent risk factors for TRAS. DM and CIT showed a tendency towards TRAS. The compound discriminatory capacity of the multivariable model (AUC = 0.775; 95% CI 0.718‒0.831) is significantly higher than systolic blood pressure and creatinine alone (AUC = 0.62; 95% CI 0.558–0.661). In body artery stenosis subgroup, DGF (OR = 1.86; 95% CI 1.04‒3.36; p = 0.03) and Diabetes Mellitus (DM) (OR = 2.44; 95% CI 1.31‒4.60; p = 0.005) were independent risk factors for TRAS. Conclusion: In our transplant population, DGF increased more than 3-fold the risk of TRAS. In the subgroup analysis, both DGF and DM increases the risk of body artery stenosis. The addition of other factors to hypertension and renal dysfunction may increase diagnostic accuracy. TRAS Trial registred: clinicaltrials.gov (n° NCT04225338). |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-08-02 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213530 10.1016/j.clinsp.2022.100087 |
url |
https://www.revistas.usp.br/clinics/article/view/213530 |
identifier_str_mv |
10.1016/j.clinsp.2022.100087 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/213530/195621 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Clinics info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Clinics |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; v. 77 (2022); 100087 Clinics; Vol. 77 (2022); 100087 Clinics; Vol. 77 (2022); 100087 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1787713183487623168 |