Can Doppler ultrasonographic indices of the renal artery predict the presence of supernumerary renal arteries?

BACKGROUND: Variations of the renal arteries, including the presence of supernumerary renal arteries, are important to be identified prior to renal transplant. Angiography has been the gold standard test for the pretransplant evaluation of the renal vasculature. However, this modality is expensive and invasive. The aim of this study was to assess whether Doppler ultrasonographic (DU) indices of the renal artery could predict the presence of supernumerary renal arteries. METHODS AND MATERIALS: Retrospectively, we analyzed multidetector computed tomography angiography (presence or absence of the supernumerary renal artery), DU (peak systolic velocity, resistive index, pulsatility index, end-diastolic velocity, and acceleration time) findings of 30 healthy potential renal transplant donors. Recipient operator characteristic (ROC) curves were used to examine the predictive values of the available DU indices for supernumerary renal arteries. RESULTS: The mean age of donors was 28.4 +/- 4.1 years. Of 60 kidneys evaluated, a supernumerary renal artery was found in 10%. The ROC curve analysis revealed an area under the curve of noninformative (below 0.5) for all DU parameters, indicating that none of the studied parameters could predict the presence of a supernumerary renal artery. CONCLUSIONS: Although the smaller diameter of the main renal artery has previously been found to predict the presence of supernumerary renal arteries, the present study revealed that DU indices of the renal artery may not indicate the presence of supernumerary renal arteries.

Safety of low-dose cyclosporine therapy before transplantation in kidney allograft recipients.

INTRODUCTION: Graft dysfunction immediately posttransplantation can vary from subtle slowing of the expected decrease in creatinine concentration to frank oliguria requiring dialysis therapy for days to weeks. Risk factors for slow and delayed graft function include prolonged preservation, older donor age, and high plasma renin activity in the recipient. Cyclosporine (CsA) nephrotoxicity is another cause of early kidney allograft dysfunction. OBJECTIVE: To evaluate early kidney allograft function in patients who received low-dose CsA therapy for 48 hours before transplant surgery for comparison with that in recipients who received CsA therapy after improvement in allograft function. PATIENTS AND METHODS: In a case-control comparative study, 66 kidney recipients were divided into 2 groups on the basis of time of initiation of CsA therapy. In group 1, patients received CsA, 100 mg twice a day, for 48 hours before surgery, and in group 2, patients received CsA therapy after surgery when allograft function had improved (serum creatinine concentration

Color Doppler findings in transplanted kidneys and remnant kidneys of donors 6 to 12 months after kidney transplantation.

OBJECTIVES: Ultrasonography and color Doppler have been used extensively in the evaluation of transplanted kidney. The aim of this study was evaluation and comparison of color Doppler sonography findings in the remnant kidney of living donors and the transplanted kidney at 6 to 12 months after kidney transplantation. METHODS: In a cross-sectional study we evaluated ultrasonographic (US) and color Doppler findings in 20 kidney allograft recipient and donors. Group 1 were unrelated and related kidney donors, and group 2, allograft recipients. Color Doppler US was performed by one sonologist on the remnant kidney of the living donor and the transplanted kidney of the recipient at 6 to 12 months after kidney donation and transplantation. We recorded, kidney size (including length and anteroposterior diameter), cortical thickness, resistive index (RI), and pulsatile index (PI). Statistical analysis was performed using SPSS 13 win (t test) for comparison of the results in donors and recipients. All data are presented as mean values +/- SD with P values less than .05 considered significant. RESULTS: In group 1, mean age of kidney allograft recipients was 39.92 +/- 11.95 years with male-to-female ratio of 1/2. Mean length, width, and cortical thickness of the transplanted kidney were 120.15 +/- 11.95 mL, 53.65 +/- 7.50 mL, and 8.53 +/- 1.00 mL, respectively. Mean RI and PI were 0.60 +/- 0.08 and 1.02 +/- 0.23, respectively. Mean serum creatinine was 1.23 +/- 0.24 mg/dL. Mean duration of renal transplantation was 7.27 +/- 1.10 months. In group 2, mean age of recipients was 25.63 +/- 3.50 years with male-to-female ratio of 1/10. Mean length, anteroposterior diameter, and cortical thickness were 120.77 +/- 9.28 mL, 53.36 +/- 4.52 mL, and 9.04 +/- 1.27 mL, respectively. Mean RI and PI were 0.60 +/- 0.02 and 1.07 +/- 0.13, respectively. There was no significant difference in the length, anteroposterior diameter, cortical thickness, RI, and PI of donors and transplanted kidneys at 6 to 12 months after transplantation (P>.05). There was a significant increase in both donor and recipient kidney size at 6 to 12 months after transplantation (P<.05). CONCLUSION: It seems that renal US and Doppler parameters remain stable in the recipient and donor at least upon short-term evaluation. Long-term study with more patients is recommended.