Ellitus Hypertension History of cardiovascular events Age of donor (years) Delayed graft function .6 days, number ( ) Living kidney donor, number ( ) Time since transplantation (months) 12 (21) 46 (79) 21 (36) 48 (42 to 57) 2 (3) 39 (67) 33 (10 to 78) 28 (48) 12 (21) 13 (22) 13 (22)1 (5) 18 (90) 5 (25) 50 (47 to 61) 2 (10) 9 (45) 35 (14 to 96)n.s. n.s. n.s. n.s. n.s. n.s. n.s.Patients were stratified according to renal arterial Licochalcone-A resistive index (RI) below or above the upper quartile threshold value of 0.66. Continuous data are presented as median (BIBS39 cost interquartile range). Non-parametric Mann-Whitney test was used to detect differences in continuous variables between the groups. Differences in categorical variables between the groups were analyzed by Fisher’s exact test. doi:10.1371/journal.pone.0051772.tRenal Arterial Resistive IndexTable 2. Biochemical characteristics of patients with renal allograft.Characteristic Hemoglobin (mmol/L) Glomerular filtration rate (CKD-EPI) (mL/min per 1.73 m2) Blood urea nitrogen (mmol/L) Serum calcium (mmol/L) Serum phosphate (mmol/L) Total cholesterol (mmol/L) C-reactive protein (mg/L)RI ,0.66 8.3 (7.5 to 9.0) 53 (39 to 70) 8.7 (6.6 to 11.3) 1.28 (1.22 to 1.32) 0.91 (0.74 to 1.01) 5.2 (4.6 to 6.0) 3 (2 to 7)RI 0.66 7.7 (7.4 to 8.7) 43 (26 to 63) 12.4 (8.9 to 17.1) 1.28 (1.22 to 1.35) 0.92 (0.77 to 0.99) 6.0 (4.5 to 6.5) 2 (1 to 4)p-value n.s. 0.05 0.05 n.s. n.s. n.s. n.s.Patients were stratified according to renal arterial resistive index (RI) below 1379592 or above the upper quartile (0.66). Continuous data are presented as median (interquartile range). Non-parametric Mann-Whitney test was used to detect differences in continuous variables between the groups. doi:10.1371/journal.pone.0051772.tother patients with renal allograft. Normal values for renal arterial resistive index in healthy subjects have been reported previously. In 135 healthy subjects without preexisting disease (median age, 37 years) the mean renal arterial resistive index was 0.59 [10]. Measurements in 34 living kidney donors showed that the resistive index in the remnant kidney of healthy donors remained stable during follow up [11]. The renal arterial resistive index was advanced as a useful parameter for quantifying the alterations in the kidney that may occur with renal disease. However, the origin of resistive index and the causes of increased resistive index in kidney diseases are not completely evaluated. Experiments on isolated perfused rabbit kidneys revealed that the renal arterial resistive index increased with decreases in the cross-sectional area of the distal arterial bed [12]. Moreover, the renal arterial resistive index has been positively correlated with histopathologic changes in the diseased kidney, i.e. with the amount of glomerular sclerosis and interstitial fibrosis in kidney biopsies [13]. Ikee et al. showed that, both, histopathologic parameters and histological signs of atherosclerosis in kidney vessels showed statistically significant correlations with renal arterial resistive index [14]. Therefore, renal scaring with vascular wall medial thickening with frequent arteriolar hyaline deposits, varying degrees of intimal fibrosis and focal glomerular ischemic changes, proportional tubular atrophy and interstitial fibrosis may cause reduced vessel area and finally increased renal arterial resistive index [15]. Alterations in the kidney tissue and inFigure 1. Kaplan-Meier estimates of the fraction of patients presenting wit.Ellitus Hypertension History of cardiovascular events Age of donor (years) Delayed graft function .6 days, number ( ) Living kidney donor, number ( ) Time since transplantation (months) 12 (21) 46 (79) 21 (36) 48 (42 to 57) 2 (3) 39 (67) 33 (10 to 78) 28 (48) 12 (21) 13 (22) 13 (22)1 (5) 18 (90) 5 (25) 50 (47 to 61) 2 (10) 9 (45) 35 (14 to 96)n.s. n.s. n.s. n.s. n.s. n.s. n.s.Patients were stratified according to renal arterial resistive index (RI) below or above the upper quartile threshold value of 0.66. Continuous data are presented as median (interquartile range). Non-parametric Mann-Whitney test was used to detect differences in continuous variables between the groups. Differences in categorical variables between the groups were analyzed by Fisher’s exact test. doi:10.1371/journal.pone.0051772.tRenal Arterial Resistive IndexTable 2. Biochemical characteristics of patients with renal allograft.Characteristic Hemoglobin (mmol/L) Glomerular filtration rate (CKD-EPI) (mL/min per 1.73 m2) Blood urea nitrogen (mmol/L) Serum calcium (mmol/L) Serum phosphate (mmol/L) Total cholesterol (mmol/L) C-reactive protein (mg/L)RI ,0.66 8.3 (7.5 to 9.0) 53 (39 to 70) 8.7 (6.6 to 11.3) 1.28 (1.22 to 1.32) 0.91 (0.74 to 1.01) 5.2 (4.6 to 6.0) 3 (2 to 7)RI 0.66 7.7 (7.4 to 8.7) 43 (26 to 63) 12.4 (8.9 to 17.1) 1.28 (1.22 to 1.35) 0.92 (0.77 to 0.99) 6.0 (4.5 to 6.5) 2 (1 to 4)p-value n.s. 0.05 0.05 n.s. n.s. n.s. n.s.Patients were stratified according to renal arterial resistive index (RI) below 1379592 or above the upper quartile (0.66). Continuous data are presented as median (interquartile range). Non-parametric Mann-Whitney test was used to detect differences in continuous variables between the groups. doi:10.1371/journal.pone.0051772.tother patients with renal allograft. Normal values for renal arterial resistive index in healthy subjects have been reported previously. In 135 healthy subjects without preexisting disease (median age, 37 years) the mean renal arterial resistive index was 0.59 [10]. Measurements in 34 living kidney donors showed that the resistive index in the remnant kidney of healthy donors remained stable during follow up [11]. The renal arterial resistive index was advanced as a useful parameter for quantifying the alterations in the kidney that may occur with renal disease. However, the origin of resistive index and the causes of increased resistive index in kidney diseases are not completely evaluated. Experiments on isolated perfused rabbit kidneys revealed that the renal arterial resistive index increased with decreases in the cross-sectional area of the distal arterial bed [12]. Moreover, the renal arterial resistive index has been positively correlated with histopathologic changes in the diseased kidney, i.e. with the amount of glomerular sclerosis and interstitial fibrosis in kidney biopsies [13]. Ikee et al. showed that, both, histopathologic parameters and histological signs of atherosclerosis in kidney vessels showed statistically significant correlations with renal arterial resistive index [14]. Therefore, renal scaring with vascular wall medial thickening with frequent arteriolar hyaline deposits, varying degrees of intimal fibrosis and focal glomerular ischemic changes, proportional tubular atrophy and interstitial fibrosis may cause reduced vessel area and finally increased renal arterial resistive index [15]. Alterations in the kidney tissue and inFigure 1. Kaplan-Meier estimates of the fraction of patients presenting wit.
