Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients

Introduction The tissue stiffness of donor kidneys in transplantation may increase due to pathological changes such as glomerulosclerosis and interstitial fibrosis, and those changes associate worse outcomes in kidney transplantation recipients. Ultrasound elastography is a noninvasive imaging exami...

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Main Authors: Tian-yi Zhang, Jiayi Yan, Jiajia Wu, Wenqi Yang, Shijun Zhang, Jia Xia, Xiajing Che, Hongli Li, Dawei Li, Liang Ying, Xiaodong Yuan, Yin Zhou, Ming Zhang, Shan Mou
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Renal Failure
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Online Access:https://www.tandfonline.com/doi/10.1080/0886022X.2023.2235015
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author Tian-yi Zhang
Jiayi Yan
Jiajia Wu
Wenqi Yang
Shijun Zhang
Jia Xia
Xiajing Che
Hongli Li
Dawei Li
Liang Ying
Xiaodong Yuan
Yin Zhou
Ming Zhang
Shan Mou
author_facet Tian-yi Zhang
Jiayi Yan
Jiajia Wu
Wenqi Yang
Shijun Zhang
Jia Xia
Xiajing Che
Hongli Li
Dawei Li
Liang Ying
Xiaodong Yuan
Yin Zhou
Ming Zhang
Shan Mou
author_sort Tian-yi Zhang
collection DOAJ
description Introduction The tissue stiffness of donor kidneys in transplantation may increase due to pathological changes such as glomerulosclerosis and interstitial fibrosis, and those changes associate worse outcomes in kidney transplantation recipients. Ultrasound elastography is a noninvasive imaging examination with the ability to quantitatively reflect tissue stiffness. Aim of this study was to evaluate the prognostic value of ultrasound elastography for adverse kidney outcome in kidney transplantation recipients.Methods Shear wave elastography (SWE) examinations were performed by two independent operators in kidney transplantation recipients. The primary outcome was a composite of kidney graft deterioration, all-cause re-hospitalization, and all-cause mortality. Survival analysis was calculated by Kaplan-Meier curves with the log-rank test and Cox regression analysis.Results A total of 161 patients (mean age 46 years, 63.4% men) were followed for a median of 20.1 months. 27 patients (16.77%) reached the primary endpoint. The mean and median tissue stiffness at the medulla (hazard ratio: 1.265 and 1.229, respectively), estimated glomerular filtration rate (eGFR), and serum albumin level were associated with the primary outcome in univariate Cox regression. Adding mean or median medulla SWE to a baseline model containing eGFR and albumin significantly improved its discrimination (C-statistics: 0.736 for the baseline, 0.766 and 0.772 for the model added mean and median medulla SWE, respectively).Conclusion The medullary tissue stiffness of kidney allograft measured by shear wave elastography may provide incremental prognostic value to adverse outcomes in kidney transplantation recipients. Including SWE parameters in kidney transplantation recipients management could be considered to improve risk stratification.
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spelling doaj-art-03c5be812714494ea2d6ed2ddd0e6a902025-08-20T02:16:11ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2235015Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipientsTian-yi Zhang0Jiayi Yan1Jiajia Wu2Wenqi Yang3Shijun Zhang4Jia Xia5Xiajing Che6Hongli Li7Dawei Li8Liang Ying9Xiaodong Yuan10Yin Zhou11Ming Zhang12Shan Mou13Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, ChinaDepartment of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, ChinaDepartment of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, ChinaDepartment of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, ChinaDepartment of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, ChinaDepartment of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, ChinaDepartment of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, ChinaDepartment of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaIntroduction The tissue stiffness of donor kidneys in transplantation may increase due to pathological changes such as glomerulosclerosis and interstitial fibrosis, and those changes associate worse outcomes in kidney transplantation recipients. Ultrasound elastography is a noninvasive imaging examination with the ability to quantitatively reflect tissue stiffness. Aim of this study was to evaluate the prognostic value of ultrasound elastography for adverse kidney outcome in kidney transplantation recipients.Methods Shear wave elastography (SWE) examinations were performed by two independent operators in kidney transplantation recipients. The primary outcome was a composite of kidney graft deterioration, all-cause re-hospitalization, and all-cause mortality. Survival analysis was calculated by Kaplan-Meier curves with the log-rank test and Cox regression analysis.Results A total of 161 patients (mean age 46 years, 63.4% men) were followed for a median of 20.1 months. 27 patients (16.77%) reached the primary endpoint. The mean and median tissue stiffness at the medulla (hazard ratio: 1.265 and 1.229, respectively), estimated glomerular filtration rate (eGFR), and serum albumin level were associated with the primary outcome in univariate Cox regression. Adding mean or median medulla SWE to a baseline model containing eGFR and albumin significantly improved its discrimination (C-statistics: 0.736 for the baseline, 0.766 and 0.772 for the model added mean and median medulla SWE, respectively).Conclusion The medullary tissue stiffness of kidney allograft measured by shear wave elastography may provide incremental prognostic value to adverse outcomes in kidney transplantation recipients. Including SWE parameters in kidney transplantation recipients management could be considered to improve risk stratification.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2235015Kidney transplantationshear wave elastographyprognosis
spellingShingle Tian-yi Zhang
Jiayi Yan
Jiajia Wu
Wenqi Yang
Shijun Zhang
Jia Xia
Xiajing Che
Hongli Li
Dawei Li
Liang Ying
Xiaodong Yuan
Yin Zhou
Ming Zhang
Shan Mou
Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients
Renal Failure
Kidney transplantation
shear wave elastography
prognosis
title Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients
title_full Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients
title_fullStr Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients
title_full_unstemmed Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients
title_short Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients
title_sort shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients
topic Kidney transplantation
shear wave elastography
prognosis
url https://www.tandfonline.com/doi/10.1080/0886022X.2023.2235015
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