Purpose
Non-dialysis patients with a glomerular filtration rate less than 20 mL/min are the best candidates for kidney transplantation (preemptive transplantation) because graft survival and patient survival are better than in dialysis patients.
Therefore,
it is necessary to carefully evaluate potential recipients of kidney transplant carefully to determine the feasibility of kidney transplantation and to detect and treat concurrent conditions that may affect graft survival (1).
The best technique to assess the vascular anatomy and concurrent illnesses of a potential candidate is the angio-CT scan.
Angio-CT...
Methods and Materials
During 2010,
20 non-diabetic patients with renal insufficiency (IV-V) (15 men and 5 women; 32-77 years,
mean 53) underwent an angio-CT scan one month before the living-donor renal transplantation.
All the patients were informed about all aspects of this clinical trial and they signed an informed consent form.
In our series,
the leading causes of chronic renal failure were polycystic kidney disease (3 patients),
IgA-associated glomerulonephritis (3 patients),
ischemic nephropathy (2 patients) and hypertension (2 patients).
Table 1shows the causes of renal failure in each...
Results
The male:female ratio was 3.2:1,
with a mean age of 53 years (R: 32-77).
Patients were followed up until transplantation.
The mean follow-up was 80 days (R: 8-369).
The average creatinine level 15 days before,
immediately before,
2 days after and 15 days after the angioCT scan were 4.43 (R:1.76-6,31),
4.6 (R: 2.07-6.64),
4.6 (R: 2.36-6.8) and 4.9 (R: 2.1-7.5),
respectively.
There were not significant differences between the levels of creatinine immediately before the CT and 2 days after the CT (0.300) (graph 1).
Only...
Conclusion
Only two patients had a significant increase in creatinine levels compatible with CIN,
but showing no persistent worsening in renal function.
This increase may be related to the use of iodinated contrast,
but a number of studies have reported an increase in creatinine level in patients who do not receive contrast material similar to that reported in series of patient receiving contrast material (10).
The patient who required dialysis 37 days after the angio-CT scan had no significant increase in creatinine levels compatible with NIC...
References
Catalá V,
Martí T,
Diaz J,
Cordeiro E,
Samaniego J,
Rosales A,
De La Torre P.
Use of Multidetector CT in Presurgical Evalua- tion of Potential Kidney Transplant Recipients.
RadioGraphics 2010; 30:517–531
Catalano C,
Fraioli F,
Laghi A,
et al.
Infrarenal aor- tic and lower-extremity arterial disease: diagnostic performance of multi-detector row CT angiography.
Radiology 2004;231(2):555–563.
Stacul F,
Adam A,
Becker CR,
Davidson C,
Lameire N,
McCullough PA,
Tumlin J; CIN Consensus Working Panel.
Strategies to reduce the risk of contrast-induced nephropathy.
Am J Cardiol...