Fehrman-Ekholm Ingela, Nordén Gunnela, Lennerling Annette, Rizell Magnus, Mjörnstedt Lars, Wramner Lars, Olausson Michael
Department of Transplantation and Liver Surgery, Sahlgrenska University Hospital, Göteborg, Sweden.
Transplantation. 2006 Dec 27;82(12):1646-8. doi: 10.1097/01.tp.0000250728.73268.e3.
The increasing use of living kidney donors requires knowledge about long-term effects, especially number and causes of donors with end-stage renal disease (ESRD).
A retrospective data analysis of 1,112 consecutive living kidney donors who underwent nephrectomy from 1965 until 2005 at Sahlgrenska University Hospital. Case reports were sought with help from nephrologists in the region and data from Swedish Registry of Active Uremic Treatment (SRAU).
The number of cases with end stage kidney failure among living kidney donors was 6/1112, that is 0.5%. The donors had reached ESRD during the years 2001-2006, that means 36-41 years after start of the living donor program. The donors were 45-89 years old, median 77 years, and five of six were males. Time since donation was 14-27 years, median 20 years, for the donors developing ESRD. The diagnoses were nephrosclerosis (4 cases), postrenal failure (1 case), and renal carcinoma (1 case). The expected incidence for development of ESRD according to incidence in the general population would have been two donors but we found six. However, considering the high age of the donors in this follow up, the age-matched incidence is calculated to be closer to six donors due to higher incidence in the aged.
In all 0.5% of the donors developed ESRD. Due to high age of the uremic donors, there seems to be no increased incidence.
活体肾供体的使用日益增加,这需要了解其长期影响,尤其是终末期肾病(ESRD)供体的数量和病因。
对1965年至2005年在萨尔格伦斯卡大学医院接受肾切除术的1112例连续活体肾供体进行回顾性数据分析。在该地区肾病学家的帮助下寻找病例报告,并获取瑞典活动性尿毒症治疗登记处(SRAU)的数据。
活体肾供体中终末期肾衰竭的病例数为6/1112,即0.5%。这些供体在2001年至2006年期间发展为ESRD,这意味着在活体供体项目开始后的36至41年。供体年龄为45至89岁,中位数为77岁,6例中有5例为男性。发展为ESRD的供体自捐赠后的时间为14至27年,中位数为20年。诊断结果为肾硬化(4例)、肾后性肾衰竭(1例)和肾癌(1例)。根据一般人群的发病率,ESRD发展的预期发病率应为2例供体,但我们发现了6例。然而,考虑到此次随访中供体的高龄,由于老年人中发病率较高,年龄匹配的发病率经计算更接近6例供体。
总体而言,0.5%的供体发展为ESRD。由于尿毒症供体年龄较大,似乎发病率没有增加。