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Evaluating
the Outcome of Percutaneous Transluminal
Angioplasty in Renal Graft Artery Stenosis Using
the Areas under the Time Curve of Glomerular
Filtration Rate and Blood Pressure J. STŘÍBRNÁ,
O. SCHÜCK, J.H. PEREGRIN, D. KRAJÍČKOVÁ, J. SKIBOVÁ
Institute
for Clinical and Experimental Medicine, Prague,
Czech Republic
Received
January 5, 2000
Accepted February 16, 2000
Summary
The
benefit of percutaneous transluminal angioplasty
(PTA) of transplant renal artery stenosis for
ischemic nephropathy may be adversely affected by
rejection or other complications. As a result,
assessment of the effect of PTA on renal function
or blood pressure is often difficult. In this
paper, we evaluated the effect of PTA using the
method of integrated glomerular filtration rate
(GFR) based upon the area under the curve over a
follow-up period (AUC0-t), to express the level
of GFR in a simple manner despite its significant
fluctuations. A similar procedure was used to
evaluate mean arterial pressure (MAP). The method
was employed to assess the outcome in 20
individuals before PTA, and 1, 3, 6, 9 and 12
months after PTA. In eight cases, rejection was
detected while there was one case of glomerulonephritis in the graft during the
follow-up period. Evaluation (AUCCcr)0-12 related
to the integrated pre-PTA value of Ccr [(Ccr)0 x
12] revealed a rise in GFR by more than 20 % in
65 % of cases. No improvement was observed in
seven individuals with post-PTA complications.
When assessing the integrated value of MAP,
success of PTA (a reduction by at least 10 %) was
found in 85 % of cases. No significant
correlation was found between the relative
changes of integrated GFR and MAP. Our data
suggest that evaluation of the integrated value
of GFR or MAP on the basis of AUC0-t allows to
characterize, in a simple manner, the level of
graft function and MAP throughout the follow-up
period in individual cases. Furthermore, it may
provide additional information on the average
values obtained at different time intervals after
the therapeutic procedure.
Key words
Renal artery graft stenosis · Angioplasty · Graft function · Blood Pressure · integrated GFR and MAP
Reprint
requests
J. Stříbrná, M.D., D.Sc., Institute for Clinical
and Experimental Medicine, Vídeňská 1958/9,
140 21 Prague 4, Czech Republic. Fax: 61363168
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