Abbott Kevin C, Viola Rebecca A, Agodoa Lawrence Y
Nephrology Service, Walter Reed Army Medical Center, Washington, DC, USA.
BMC Nephrol. 2002 Nov 26;3:10. doi: 10.1186/1471-2369-3-10.
The national incidence of and risk factors for hospitalized poisonings in renal transplant recipients has not been reported.
Historical cohort study of 39,628 renal transplant recipients in the United States Renal Data System between 1 July 1994 and 30 June 1998. Associations with time to hospitalizations for a primary diagnosis of poisonings (ICD-9 codes 960.x-989.x) within three years after renal transplant were assessed by Cox Regression.
The incidence of hospitalized poisonings was 2.3 patients per 1000 person years. The most frequent causes of poisonings were immunosuppressive agents (25.3%), analgesics/antipyretics (14.1%), psychotropic agents (10.0%), and insulin/antidiabetic agents (7.1%). In Cox Regression analysis, low body mass index (BMI, <21.6 vs. >28.3 kg/m2, adjusted hazard ratio (AHR), 3.02, 95% CI, 1.45-6.28, and allograft rejection, AHR 1.83, 95% CI, 1.15-2.89, were the only factors independently associated with hospitalized poisonings. Hospitalized poisonings were independently associated with increased mortality (AHR, 1.54, 95% CI 1.22-1.92, p = 0.002).
Hospitalized poisonings were associated with increased mortality after renal transplantation. However, almost all reported poisonings in renal transplant recipients were due to the use of prescribed medications. Allograft rejection and low BMI were the only independent risk factors for poisonings identified in this population.
肾移植受者住院中毒的全国发病率及危险因素尚未见报道。
对1994年7月1日至1998年6月30日期间美国肾脏数据系统中的39628例肾移植受者进行历史性队列研究。通过Cox回归评估肾移植后三年内初次诊断为中毒（国际疾病分类第九版编码960.x - 989.x）的住院时间相关因素。
住院中毒的发病率为每1000人年2.3例患者。中毒最常见的原因是免疫抑制剂（25.3%）、镇痛/退热药（14.1%）、精神药物（10.0%）和胰岛素/抗糖尿病药物（7.1%）。在Cox回归分析中，低体重指数（BMI，<21.6 vs. >28.3 kg/m²，调整后风险比（AHR），3.02，95%置信区间，1.45 - 6.28）和移植肾排斥反应（AHR 1.83，95%置信区间，1.15 - 2.89）是与住院中毒独立相关的唯一因素。住院中毒与死亡率增加独立相关（AHR，1.54，95%置信区间1.22 - 1.92，p = 0.002）。
肾移植后住院中毒与死亡率增加相关。然而，肾移植受者中几乎所有报告的中毒都是由于使用了处方药。移植肾排斥反应和低BMI是该人群中确定的中毒唯一独立危险因素。
