Color Doppler indexes in early phase after kidney transplantation and their association with kidney function on six month follow up


1 Radiology Department, Isfahan University of Medical science, Isfahan, Iran

2 Isfahan kidney diseases research center, Isfahan University of Medical science, Isfahan, Iran

3 Nephrology Department, Isfahan University of Medical science, Isfahan, Iran


Background: Doppler ultrasonography (DU) and measurement of its indexes, resistive index (RI) and pulsatility index (PI), is used to investigate transplanted kidney hemodynamic status and function. The aim of this study was to determine the correlation between Doppler indexes in the early phase after transplantation with long-term transplanted kidney function.
Materials and Methods : In this cross-sectional study on 38 newly kidney transplant patients, we performed DU with assessment of its indexes within 48 hours, 1 week, and 6 months after kidney transplantation. Serum creatinine after stability and 6 months after kidney transplantation were assessed. Cyclosporine level was measured 1 week after kidney transplantation and compared with DU indexes.
Results: About 71% of kidney transplanted patients reached their normal initial creatinine level(cr<1.5 mg/ dl) and 28% of all patients were involved in kidney dysfunction after 6 months (increase in basic creatinine level more than 25%).There was no significant difference between mean RI and PI in patients with normal and disturbed kidney function based on creatinine level in early posttransplantation period but there was linear correlation between mean RI and PI within 48 hours and 1 week with kidney function after 6 months. Also no association between cyclosporine level and RI and PI was shown. There was a direct association between age and the levels of RI and PI 6 months after transplantation.
Conclusion: This study suggests assessment of RI and PI in early period after transplantation and can be used as predictive parameters for long-term function of transplanted kidney and RI more than 0.80 in early phase after transplantation has an acceptable sensitivity and specificity to predict long-term kidney dysfunction.


1. Doppler ultrasound evaluation of renal transplant [homepage on the Internet]. 2010. Available from: [Last accessed on 2011].  Back to cited text no. 1
2. Al-khulaifat S. Evaluation of a transplanted kidney by Doppler ultrasound. Saudi J Kidney Dis Transpl 2008;15:730-6.  Back to cited text no. 2
3. Malfi B, Cogno C, Rabbia C, Messina M, Monga G, Mazzucco G, et al. Comparison between biopsy data and the resistive index obtained by Doppler echography in the evaluation of the transplanted kidney. Minerva Urol Nefrol 1992;44:261-4.  Back to cited text no. 3
4. Boas FE, Desser TS, Kamaya A. Does separating the resistive index into pre-and post glomerular resistance and vascular compliance improve the diagnostic accuracy of renal transplant Doppler ultrasound?. Am J Radiol 2011;87:196-201.  Back to cited text no. 4
5. Tublin ME, Bude RO, Platt JF. The resistive index in renal Doppler sonography: Where do we stand?. Am J Roentgenol 2003;180:885-92.  Back to cited text no. 5
6. Platt JF, Rubin JM, Ellis JH. Lupus nephritis: Predictive value of conventional and Doppler US and comparison with Serologic and biopsy parameters. Radiology 1997;203:82-6.  Back to cited text no. 6
7. Radermacher J,Mengel M,Ellis S,Stuht S, Hiss M, Schwarz A, et al. The Renal Arterial Resistance Index and Renal Allograft Survival.N Engl J Med 2003;349:115-24.  Back to cited text no. 7
8. Heine.GH,GerhartMK,Ulrich C,Kohler H,Girndt M. Rental Doppler resistance indices are associated with systemic atherosclerosis in kidney transplant recioients. Kidney Int 2005;68:87885.  Back to cited text no. 8
9. McArthur C, Geddes CC, Boxter GM. Early measurement of pulsatility and resistive indexes: Correlation with long-term renal transplant function. Radiology 2011; 259:278-85.  Back to cited text no. 9
10. Kahraman S, Genctoy G, Cil B, Yilmaz R, Arici M, Altun B, et al. Perediction of renal allograft function with early Doppler ultrasonography. Transplant Proc 2004;36:1348-51.  Back to cited text no. 10
11. Breitenseher M, Helbich T, Kainberger F, Hübsch P, Trattnig S, Traindl O, et al. Color Doppler ultrasound of kidney transplants. Does the resistance index facilitate diagnosis of chronic kidney Failure? Ultraschall Med 1994;15:24-8.  Back to cited text no. 11
12. Gabriel MD. Handbook of Kidney Transplantation. 5th ed. Lippincott Williams and Wilkins; 2012.  Back to cited text no. 12
13. Dipallo FQ, Rivolta R, Elli A, Castagnone D, Abelli P, Zafiropulu S, et al. Effect of cyclosporin A on renal cortical resistances measured by color Doppler flow metry on renal grafts. Nephron 1993;65:240-4.  Back to cited text no. 13
14. Trillaud H,Merville P, LeLinh PT,Palussiere J, Potaux L, Grenier N. Color Doppler Sonography in Early, Renal Transplantation Follow-Jp: ResistiveIndex MeasurementsVersus Power Doppler Sonography. Am J Radiol 1998;171:1611-5.  Back to cited text no. 14
15. Bolboaca SD, Lucan MD, Botar-Jid C, et al. Daily monitoring patients with renal transplant: A way to better understand to relationship between Doppler indices and renal function. European Congress of radiaology; 2004 March 5-9; Austria.  Back to cited text no. 15
16. Saracino A, Santarsia G, Latorraca A, Gaudiano V. Early assessment of renal resistance index after kidney transplant can help predict long-term renal function. Nephrol Dial Transplant 2006;21:2916-20.  Back to cited text no. 16
17. Akgul A, Lbis A, Sezar S, Basaran C, Usluogullari A, Ozdemir FN, et al. Early assessment of renal resistance index and long term renal function in renal transplantation recipients. Ren Fail 2009;31:18-24.   Back to cited text no. 17
18. Krumme B,Grotz W,Kirste G,Schollmeyer P, Rump LC. Determinants of Intrarenal Doppler Indices in Stable Renal Allografts. J Am Soc Nephrol 1997;8:813-6.  Back to cited text no. 18
19. Nouri-Majelan N, Nafici R. Duplex sonographic, measurements in allografted kidneys: A cross-sectional study. Transplant Proc 2007;39:1103-7.   Back to cited text no. 19
20. Ardalan MR, Tarzamani MK, Mortaazavi M, Bahloli A. Relation between resistive index and serum creatinine level in first month after renal transplantation. Transplant proc 2003;35:2628-9.  Back to cited text no. 20