Shoskes Daniel, Lapierre Chantale, Cruz-Correa Marcia, Muruve Nicolas, Rosario Reinaldo, Fromkin Beth, Braun Mauro, Copley John
Department of Kidney Transplantation, Cleveland Clinic Florida, Weston, FL, USA.
Transplantation. 2005 Dec 15;80(11):1556-9. doi: 10.1097/01.tp.0000183290.64309.21.
The bioflavonoids quercetin and curcumin are renoprotective natural antioxidants. We wished to examine their effects on early graft function (EF).
Between September 2002 and August 2004, 43 dialysis dependent cadaveric kidney recipients were enrolled into a study using Oxy-Q which contains 480 mg of curcumin and 20 mg of quercetin, started after surgery and taken for 1 month. They were randomized into three groups: control (placebo), low dose (one capsule, one placebo) and high dose (two capsules). Delayed graft function (DGF) was defined as first week dialysis need and slow function (SGF) as Cr >2.5 mg/dl by day 10. Category variables were compared by chi squared and continuous variables by Kruskal-Wallis.
There were four withdrawals: one by patient choice and three for urine leak. The control group had 2/14 patients with DGF vs. none in either treatment group. Incidence of EF was control 43%, low dose 71% and high dose 93% (P=0.013). Serum creatinine was significantly lower at 2 days (control 7.6+/-2.1, low 5.4+/-0.6, high 3.96+/-.35 P=0.0001) and 30 days (control 1.82+/-.16, low 1.65+/-.09, high 1.33 +/-.1, P=0.03). Acute rejection incidence within 6 months was control 14.3%, low dose 14.3% and high dose 0%. Tremor was detected in 13% of high dose patients vs. 46% of others. Urinary HO-1 was higher in bioflavonoid groups.
Bioflavonoid therapy improved early graft function. Acute rejection and neurotoxicity were lowest in the high dose group. These bioflavonoids improve early outcomes in cadaveric renal transplantation, possibly through HO-1 induction.
生物类黄酮槲皮素和姜黄素是具有肾脏保护作用的天然抗氧化剂。我们希望研究它们对早期移植肾功能（EF）的影响。
在2002年9月至2004年8月期间，43例依赖透析的尸体肾移植受者被纳入一项使用含480毫克姜黄素和20毫克槲皮素的Oxy-Q的研究，术后开始服用，持续1个月。他们被随机分为三组：对照组（安慰剂）、低剂量组（一粒胶囊，一粒安慰剂）和高剂量组（两粒胶囊）。移植肾功能延迟恢复（DGF）定义为术后第一周需要透析，缓慢恢复功能（SGF）定义为术后第10天肌酐>2.5毫克/分升。分类变量采用卡方检验进行比较，连续变量采用Kruskal-Wallis检验进行比较。
有4例退出研究：1例因患者选择，3例因尿漏。对照组有2/14例患者出现DGF，而两个治疗组均无。EF发生率在对照组为43%，低剂量组为71%，高剂量组为93%（P=0.013）。术后2天（对照组7.6±2.1，低剂量组5.4±0.6，高剂量组3.96±0.35，P=0.0001）和30天（对照组1.82±0.16，低剂量组1.65±0.09，高剂量组1.33±0.1，P=0.03）时血清肌酐显著更低。6个月内急性排斥反应发生率在对照组为14.3%，低剂量组为14.3%，高剂量组为0%。高剂量组13%的患者出现震颤，而其他组为46%。生物类黄酮组尿中血红素加氧酶-1（HO-1）水平更高。
生物类黄酮治疗可改善早期移植肾功能。高剂量组急性排斥反应和神经毒性最低。这些生物类黄酮可能通过诱导HO-1改善尸体肾移植的早期结局。
