https://scholars.lib.ntu.edu.tw/handle/123456789/591861
標題: | Intrarenal vascular resistance parameters in kidney transplant patients receiving calcineurin inhibitor-based or sirolimus-based regimens | 作者: | PO-CHU LEE CHIH-YUAN LEE REY-HENG HU Chiao Lo MENG-KUN TSAI PO-HUANG LEE |
公開日期: | 五月-2010 | 卷: | 25 | 期: | 5 | 起(迄)頁: | 1675 | 來源出版物: | Nephrology Dialysis Transplantation | 摘要: | Background. Use of a calcineurin inhibitor (CNI) immunosuppressant following kidney transplantation is associated with development of vasomotor nephrotoxicity. This study was undertaken to evaluate and compare the influences of CNI-based and CNI-free immunosuppressant regimens on two intrarenal vascular resistance parameters, the resistive index (RI) and the pulsatility index (PI), in renal transplant recipients.Methods. Forty-nine renal transplant patients who received ultrasonography examination between January 2007 and December 2007 were enrolled in this case-control study. Thirty-one subjects received a CNI-based regimen, and 18 received a CNI-free (sirolimus-based) regimen. RI and PI were determined by duplex Doppler ultrasonography.Results. Patients receiving a CNI displayed lower cholesterol and triglyceride values and higher RI (mean: 0.7 vs. 0.6, P = 0.002) and PI values (mean: 1.3 vs. 1.1, P = 0.034). Multivariate analyses revealed that advanced age and use of alpha-blockers or diuretics were modestly associated with higher RI and PI values. By multivariate analysis, use of sirolimus was associated with a lower RI by-0.05 [95% confidence interval (CI):-0.085,-0.019; P = 0.003] but not with a lower PI (95% CI:-0.245, 0.001; P = 0.053).Conclusions. Use of sirolimus is only modestly correlated with a reduced RI and is not associated with a reduced PI. These observations question the superiority of CNI-free over CNI-based regimens with regard to reduction of intrarenal vascular resistance post-transplantation. These findings combined with those regarding recipient factors also cast doubt on the specificity of intrarenal resistance indices for predicting allograft function and/or survival. © The Author 2009. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-77951687018&doi=10.1093%2fndt%2fgfp716&partnerID=40&md5=d96ab9a7bfdb72bb8ac259969860818f https://scholars.lib.ntu.edu.tw/handle/123456789/591861 |
ISSN: | 0931-0509 | DOI: | 10.1093/ndt/gfp716 |
顯示於: | 醫學系 |
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