Duplex-Sonographie in der Diagnostik von Nierenarterienstenosen nach allogener Nierentransplantation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1989-09

AUTHORS

G. Winde, B. Buchhol, W. Krings, H. Bünte, P. Preusser, W. Pircher, M. Möllmann, W. Tenschert

ABSTRACT

Posttransplant renal artery stenosis (TRAS) as a cause of secondary hypertension is reported with an incidence of 1 to 10%. Early diagnosis of TRAS should be made by non-nephrotoxic and non-invasive means to lower the risk of hypertension. One to 66 months after kidney transplantation 335 patients underwent Duplex-scanning, 38 of cases for clinical tentative diagnosis of TRAS. Parameters for clinical diagnosis of TRAS were diastolic hypertension > 100 mm Hg with resistance to therapy (A), an abdominal bruit over the transplant (B), disturbance of renal function (serum-creatinin > 2 mg/dl) (C). Admission to study followed the parameter-combination A + B, A + C, B + C. Rejection crisis was excluded in 18/38 cases by fine needle biopsy, cyclosporine over-dosage was negative in 38/38 cases, 20/38 cases had normal renal function. Duplex-/Doppler-ultrasound criteria for TRAS were systolic peak velocity > 100 cm/s−1 and broadening of the diastolic frequency spectra with a smooth decline in diastole to an elevated diastolic level. In 32/38 cases (84.2%,n=38) diagnosis of TRAS was made by duplex-scanning, angiography confirmed the result in 30/32 cases (93.75%,n=32); sensitivity was 88.2% with a specifity of 66.6%. Duplex-scanning as a primary diagnostic means for TRAS seems a promising method compared to e.g. radionuclide imaging or angiography. Duplex-scanning is a non-nephrotoxic and non-invasive procedure repeatable at any time with only few preliminary conditions. Moreover, Duplex-scanning can be used as a screening method in ambulant graft-care in observation of the clinical course after PTA or desobliteration. So graft-recipient and organ prognosis could be improved by early diagnosis of TRAS and adapted antihypertensive medication. More... »

PAGES

284-290

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf01261471

DOI

http://dx.doi.org/10.1007/bf01261471

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1006826190

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/2682097


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