Serial Changes of Serum Creatinine and Resistive Index to Predict Acute Rejection after Renal Transplantation

Lee, Seh Ra; Kwon, Oh Jung; Koh, Byung Hee; Kwak, Jin Young

Abstract

The purpose of this study was comparing the serial change of serum creatinine and Resistive Index (RI) after renal transplantation. From Jul. 1995 to Feb. 1997, we examined Doppler sonography for 32 out of 99 patients, who were undertaken renal transplantation, whose resistive index were taken at POD #1 and POD #5 and named initial resistive index. The late resistive index were examined when they discharged or when the acute rejection was suspicious. The RI rejection group, which was consist of 22 out of 32 patients, were selected whose late resistive index were increased more 0.05 than inital resistive index. The RI control group, which was consist of 10 out of 32 patients, was selected whose late resistive index were not more 0.05 than initial resistive index. The group which was consist of 21 patient, had over 1.8 mg/dL of serum creatinine. The rest, 11 patients, had not more than 1.8 mg/dL of serum creatinine. The Student's T-test was used for the statistical analysis. In the RI rejection group, late RI value (0.77+/-0.04) was significantly higher than initial RI (p<0.05) and the increase of RI in the acute rejection group were significantly greater than that in the control group (p<0.05). With the serial changes of late RI more 0.05 than initial RI, we obtained 85.0% of sensitivity and 58.3% of specificity for the prediction of the acute rejection. In the patients with the serum creatinine over 1.8 mg/dL, the sensitivity was 85.0% and the specificity was 66.7%. In the patients with the serum creatinine over 1.8 mg/dL and increased RI over 0.05, the sensitivity was 94.1% and specificity was 66.7%. The result shows that serial changes of duplex Doppler scan and the level of serum creatinine after renal transplantation were not enough to predict acute rejection. But the correlation of the result show more higher sensitivity. We suggest to be able to use the Doppler sonography and serial changes of serum creatinine level with the other clinical findings to predict the acute rejection after renal transplantation.