Asunto(s)
Población Negra , Rechazo de Injerto/epidemiología , Rechazo de Injerto/prevención & control , Terapia de Inmunosupresión/métodos , Trasplante de Riñón/inmunología , Grupos Raciales , Adolescente , Adulto , Anciano , Algoritmos , Suero Antilinfocítico/uso terapéutico , Femenino , Prueba de Histocompatibilidad , Humanos , Masculino , Persona de Mediana Edad , Muromonab-CD3/uso terapéutico , Estados UnidosRESUMEN
Renal computed tomography (CT), 3-dimensional CT angiography (3D-CTA), and simultaneous measurement of glomerular filtration rate (GFR) by x-ray fluorescence determination of plasma contrast clearance (PCC) are alternatives to intravenous urography (IVU), renal arteriography (RA), and 24-hr urine creatinine clearance (CrCl) for evaluation of renal structure and function in living renal donor (LRD) candidates. To determine if CT, 3D-CTA, and PCC provide data comparable to IVU, RA, and CrCl, both methods were used to evaluate 23 LRD candidates. Costs were also compared. Conventional RA identified 19 accessory arteries and one case of medial fibroplasia. Each of these anomalous vessels was recognized on 3D-CTA. Venous anatomy was more clearly delineated on 3D-CTA than the venous phase of conventional RA. CT demonstrated 3 benign cysts and a single, small intraparenchymal calcification in 3 renal units. GFRs measured by PCC and CrCl were 91 +/- 4 and 132 +/- 7 ml/min/1.73m2, respectively (r = 0.64, P < 0.05). Total cost for CT/3D-CTA/PCC was 46% less than that of IVU/RA/CrCl and 40% less than RA/CrCl. CT/3D-CTA/PCC provided reliable structural and functional data at substantially less cost, discomfort, and inconvenience to the living renal donor candidate. As such, CT/3D-CTA/PCC is superior to conventional methods for evaluation of the living renal donor candidate.
Asunto(s)
Angiografía/economía , Trasplante de Riñón/economía , Riñón/diagnóstico por imagen , Donantes de Tejidos , Tomografía Computarizada por Rayos X/economía , Adulto , Angiografía/métodos , Medios de Contraste , Costos y Análisis de Costo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X/métodosRESUMEN
This is the third in a series of annotated bibliographies on research topics that will appear in the ANNA Journal. The bibliographies were prepared by members of ANNA's Research Special Interest Group, which was chaired by Nancy Hoffart, PhD, RN, in 1991-1992 and is currently chaired by Donna Hathaway, PhD, RN. Each bibliography focuses on a particular topic and includes reviews of research books and articles published in nursing and allied health journals in recent years. This series is intended to assist nephrology nurse researchers in locating resources to plan and implement research studies and to communicate and implement research findings. The annotation for each item includes a full citation, a brief summary, and a categorization of the content level. The following key was used in rating the content level for each citation: (a) Basic/Introductory--For professionals who have no previous research background; (b) Intermediate--For professionals who possess some knowledge of the research process and terminology, and have participated in some research projects; and (c) Advanced--For professionals who possess broad knowledge and experience with research projects. The topics in this issue cover poster preparation, abstract writing, and collaborative research. Contributors to this bibliography were Billie J. Kostro, Christine Mudge, and Karen L. Yennie. The first installment covered grant writing (see February 1993 issue, volume 20, number 1). The second installment covered development of a research proposal, literature review, and theoretical and conceptual frameworks (see April 1993 issue, volume 20, number 2).(ABSTRACT TRUNCATED AT 250 WORDS)