Kidney transplantation stands as a practical and cost-effective treatment option for end-stage renal disease patients, offering an improved quality of life with reduced morbidity when compared with hemodialysis. To evaluate the status of transplanted kidneys in Saudi patients, we conducted a retrospective single-center study at Jazan, Saudi Arabia, involving 46 adult renal recipients enrolled randomly from 2015 to December 2022. Using high-frequency ultrasound, we performed Duplex ultrasound examinations to assess renal allografts. The study revealed that the renal grafts exhibited normal length, with preserved cortical medullary differentiation (CMD) in 84.8% of cases and poor CMD in 15.2%. The echogenicity of the grafts remained normal in 69.6% of instances. Interestingly, we observed a significant rise in resistance index values as the graft duration increased (P = .04), whereas patients with abnormal creatinine levels displayed decreased peak systolic velocity and end-diastolic velocity. Notably, sonographic graft assessments unveiled complications, including perinephric fluid accumulation (8.7%), simple renal cysts (10.86%), hydronephrosis (8.7%), and one case of graft rejection. Receiver operating characteristics analysis for serum blood creatinine levels and abnormal parenchymal findings yielded fair to poor predictive accuracy, with varying sensitivity and specificity measures that lacked statistical significance. In conclusion, our study revealed that most Saudi renal transplant recipients exhibited grafts with normal echogenicity, preserved CMD, and limited perinephric fluid. This investigation provides valuable insights into sonographic changes and Doppler parameters of renal grafts, potentially aiding in the early detection of graft rejection and facilitating diagnostic and therapeutic planning.
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