Evaluation of the results of percutaneous transluminal angioplasty of arterial stenosis in the transplanted kidney using area under time curves of the glomerular filtration rate and blood pressure
Stríbrná, J.; Schück, O.; Peregrin, J.H.; Krajícková, D.; Skibová, J.
Vnitrni Lekarstvi 45(12): 691-695
1999
ISSN/ISBN: 0042-773X PMID: 10951842 Document Number: 504812
The benefit of percutaneous transluminal angioplasty (PTA) of renal transplant artery stenosis for renal hemodynamics is frequently adversely affected by rejection or another complication. As a result, evaluation of the effect of PTA is often difficult. Our study was designed to assess the effect of PTA using a method of integrated value of the glomerular filtration rate (GFR) calculated on the basis of the area under the curve over the follow-up period (AUC0-t). A similar procedure was employed to evaluate mean arterial pressure (MAP). The method was used to assess the outcome in 20 individuals before to PTA, and at 1, 3, 6, 9 and 12 months after angioplasty. A rejection episode was diagnosed in eight cases and glomerulonephritis of the graft in one. Using the evaluation of (AUCCcr)0-12 in relation to the integrated value before PTA (Ccr) x 12, a rise in GFR > 20% was found in 65% of cases. PTA failure was observed in seven individuals developing post-PTA complications. When assessing the integrated value of MAP, PTA was found to be successful (a reduction by at least 10%) in 85% of cases. No significant correlation was demonstrated between the integrated values of GFR and MAP. The results support the assumption that the evaluation of the integrated values of GFR or MAP using AUC0-t allows to characterize, in a simple manner, the degree of renal transplant function or MAP throughout the follow-up period, and to furnish additional information to the values obtained at individual time intervals after the therapeutic procedure.