Bock H A, Gregor M, Huser B, Rist M, Landmann J, Thiel G
Abteilungen für Nephrologie, Urologie und Organtransplantation, Kantonsspital Basel.
Schweiz Med Wochenschr. 1991 Dec 7;121(49):1833-5.
23 living related kidney transplant donors were prospectively studied to determine the degree of hyperfiltration which occurs after uninephrectomy and to monitor potential consequences of this procedure such as hypertension, microalbuminuria or renal functional impairment. Standard inulin and PAH clearance studies were performed immediately before (n = 23), one week after (n = 22) and one year after nephrectomy (n = 12). Hyperfiltration was defined as the ratio of (post-nephrectomy inulin clearance)/(0.5 x pre-nephrectomy inulin clearance), hyperperfusion was defined in an analogous way for PAH clearance. One week after uninephrectomy, hyperfiltration averaged 134 +/- 6% (SEM) and hyperperfusion was 138 +/- 6%. The degree of hyperfiltration did not correlate with donor age. One year after nephrectomy, hyperfiltration was nearly unchanged (130 +/- 7%) whereas hyperperfusion had significantly decreased to 119 +/- 8% (p less than 0.05). Blood pressure did not increase after nephrectomy and no new cases of hypertension were observed during follow-up. In contrast, there were two new cases of microalbuminuria at one week and one year after nephrectomy. Further follow-up of these kidney donors is warranted.
对23名活体亲属肾移植供体进行前瞻性研究,以确定单侧肾切除术后发生的高滤过程度,并监测该手术的潜在后果,如高血压、微量白蛋白尿或肾功能损害。在肾切除术前(n = 23)、术后1周(n = 22)和术后1年(n = 12)立即进行标准菊粉和对氨基马尿酸清除率研究。高滤过定义为(肾切除术后菊粉清除率)/(0.5×肾切除术前菊粉清除率)的比值,高灌注以类似方式根据对氨基马尿酸清除率定义。单侧肾切除术后1周,高滤过平均为134±6%(标准误),高灌注为138±6%。高滤过程度与供体年龄无关。肾切除术后1年,高滤过几乎无变化(130±7%),而高灌注显著降至119±8%(p<0.05)。肾切除术后血压未升高,随访期间未观察到新的高血压病例。相比之下,肾切除术后1周和1年有2例新的微量白蛋白尿病例。有必要对这些肾供体进行进一步随访。