Relationship between renal resistance index and renal function in liver transplant recipients after cessation of calcineurin inhibitor

Eisenberger, Ute; Sollinger, Daniel; Stickel, Felix; Burckhardt, Beat; Frey, Felix J (2009). Relationship between renal resistance index and renal function in liver transplant recipients after cessation of calcineurin inhibitor. Clinical transplantation, 23(4), pp. 499-504. Oxford: Wiley-Blackwell 10.1111/j.1399-0012.2009.00986.x

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End stage renal disease is a major complication after orthotopic liver transplantation (OLT). Vasoconstriction of renal arterial vessels because of calcineurin inhibitor (CNI) treatment plays a pivotal role in the development of renal insufficiency following OLT. Renal resistance can be measured non-invasively by determining the resistance index (RI) of segmental arteries by color-coded duplex ultrasonography, a measure with predictive value for future renal failure. Sixteen OLT patients on long-term CNI therapy were recruited prospectively and randomly assigned either to receive the m-TOR inhibitor sirolimus (SRL) or to continue on CNI treatment, and were followed for one yr. Serum creatinine (crea) declined after conversion to SRL, whereas it tended to increase in patients remaining on CNI (meanDelta crea SRL: -27, -18, -18, -15 micromol/L; meanDelta crea CNI: 4, 5, 8, 11 micromol/L at 1, 3, 6, 12 months, p = 0.02). RI improved after switching to SRL and was lower on SRL than on CNI (meanDeltaRI SRL: -0.04, -0.04, -0.03, -0.03; meanDeltaRI CNI: -0.006, 0.004, -0.007, -0.01 after 1, 3, 6, 12 months, p = 0.016). Individual changes of RI correlated significantly with individual changes of crea (r = 0.54, p < 0.001). Conversion from CNI to SRL can ameliorate renal function accompanied by a reduction of intrarenal RI after OLT.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology

UniBE Contributor:

Eisenberger, Ute; Stickel, Felix and Frey, Felix Julius

ISSN:

0902-0063

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:10

Last Modified:

06 Dec 2013 13:57

Publisher DOI:

10.1111/j.1399-0012.2009.00986.x

PubMed ID:

19486346

Web of Science ID:

000268481700010

URI:

https://boris.unibe.ch/id/eprint/30842 (FactScience: 195174)

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