Kidney Failure Clinical Trial
Official title:
Correlation Between Renal Vascular Resistive Index, Renal Allograft Histology and Outcome
The purpose of this study is to evaluate the prognostic performance of intrarenal resistive index in the first years after kidney transplantation on graft function and on patient and graft survival. In addition, the determinants of the intrarenal resistive index, including a detailed analysis of the relation between graft histology and the intrarenal resistive index, will be assessed.
Since March 2004, and as part of routine clinical practice, protocol renal allograft
biopsies are routinely performed at implantation and at 3, 12 and 24 months after
transplantation, in all patients who receive a kidney transplant at the University Hospitals
Leuven, unless there is a medical contra-indication or patient refusal to undergo this
procedure. The biopsies are scheduled using a dedicated Microsoft Access database ("Biopsy
Database"), that is maintained on the central servers of the University Hospitals Leuven.
Patients who have an unexplained change in renal allograft function, undergo additional
clinically indicated indication biopsies. These biopsies are also recorded in the
aforementioned Microsoft Access Database.
All clinical data, including pretransplant donor and recipient characteristics, and
post-transplant follow-up data are directly stored and maintained in a prospectively
collected electronic database (CCL database until 06/2012, transferred to the central KWS
database in 2012). This electronic database is the only existing clinical database for these
patients, and contains all clinical patient charts. No written records are collected.
All renal allograft biopsies will be rescored by a single renal pathologist according to the
most recent Banff classification, blinded for the clinical parameters and timing of the
biopsy. These rescoring data are directly entered in the dedicated Microsoft Access database
("Biopsy Database").
Just prior to performing a renal allograft biopsy with ultrasound guidance, and as part of
the routine clinical procedure, duplex measurements are performed by the radiologist who
will perform the biopsy. The peak systolic velocity (Vmax) and the minimal diastolic
velocity (Vmin) are determined in each patient in two to three representative interlobar
arteries. The resistive index is calculated as [1 - (V min/V max)]. This procedure is
repeated at three different places in the kidney (lower, interpolar and upper pole). These
data are directly entered in the central electronic clinical database system (KWS, see
above).
All electronic data will be transferred to a SAS database at time of data extraction.
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Observational Model: Cohort, Time Perspective: Prospective
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