Date: Saturday, May 30, 2020
Session Name: Kidney: Cardiovascular and Metabolic Complications II
Session Time: 3:15pm-4:45pm
Presentation Time: 3:39pm-3:51pm
*Purpose: The aim of the study is to evaluate the clinical application of CHAIR score based on creatinine (C), hypertension (H), age (A), imaging evidence of angiostenosis (I), and Renin-ACA-aldostrone system (RAAS, R) in diagnosing the severity of transplant renal artery stenosis (TRAS) for selection of patients potentially requiring endovascular intervention and predicting the timing of intervention.
*Methods: A retrospective, institutional review board-approved study of TRAS patients at a single institution was conducted. From April 2016 to June 2019, 353 patients with renal transplantation were reviewed and 25 patients of them with TRAS were found and confirmed by imaging evidence. The score of each of the 25 patients is calculated according to the criteria in Table 1 based on risk stratification. A total CHAIR score of 8 or greater is considered high risk and a score of 5 or less is considered low risk. The Mid-range scores (6 and 7) is considered medium risk. All data were obtained through the electronic health record.
*Results: According to the CHAIR score among them, three cases in the low risk were observed dynamically. Five cases was in the medium risk and two of them received arteriography of transplanted kidney followed by only one case treated with balloon dilation, and the other three cases were observed dynamically. There were 17 cases in the high risk, who were all treated with angiography, and to whom balloon dilatation therapy was given immediately after TRAS was confirmed. The creatinine of 19 patients was (292.9 ± 165.6) umol / L before intervention, and decreased to (190.3 ± 130.5) umol / L after intervention. The difference was statistically significant (P < 0.05). The peak systolic blood flow of the stenosis site was (328.2 ± 194.8) cm / S before intervention and (180.2 ± 129.7) cm / s after intervention. The difference was also statistically significant (P < 0.05). The CHAIR score were related to the severe extent of TRAS.
*Conclusions: The CHAIR score has the function of evaluating the severity of TRAS and prompting the timing of intervention to some extent, which may allow for a more appropriate and individualized treatment for TRAS patients. Patients with scores ≥ 8 often need to take timely intervention to benefit from it.
|Score||Creatinine (C)||Hypertension (H)||Age (A)||Imaging evidence of angiostenosis(I)||RAAS (R)|
|0||Normal or stable creatinine||Normal blood pressure||<40 years||Normal|
|1||Elevation <20%||1 grade||≥40 years||<50%||Elevation|
|2||Elevation ≥20%;<50%||2 grade||≥50%;<70%|
|3||Elevation ≥50%||3 grade||≥70%;<90%|
To cite this abstract in AMA style:Tian X, Duan W, Yan T, Wu X. CHAIR Score: A Novel Risk Stratification in Transplant Renal Artery Stenosis [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/chair-score-a-novel-risk-stratification-in-transplant-renal-artery-stenosis/. Accessed April 20, 2021.
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