既往肾捐献者中估算的肾小球滤过率（eGFR）低于60ml/（min·1.73m²）的危险因素。
Risk factors for MDRD-GFR of less than 60 mL/min per 1.73 m2 in former kidney donors.
作者信息
Lee Jang Han, Kim Song Cheol, Han Duck Jong, Chang Jai Won, Yang Won Seok, Park Su Kil, Lee Sang Koo, Park Jung Sik, Kim Soon Bae
机构信息
Division of Nephrology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
出版信息
Nephrology (Carlton). 2007 Dec;12(6):600-6. doi: 10.1111/j.1440-1797.2007.00852.x.
BACKGROUND
Although several previous studies have reported that kidney donors are not at increased risk for adverse effects, some donors have been found to progress to chronic kidney disease (CKD). We retrospectively evaluated the risk factors for estimated glomerular filtration rate (GFR) from abbreviated Modification of Diet in Renal Disease (MDRD) equation (MDRD-GFR) of less than 60 mL/min per 1.73 m2 in kidney donors.
METHODS
Of the 756 individuals who underwent open donor nephrectomy between 27 June 1990 and 30 April 2001, 104 had follow-up records for 50 months or more. MDRD-GFR of 60 mL/min per 1.73 m2 at final follow up divided these individuals into a normal group (n = 78) and a CKD-GFR group (n = 26). We compared several clinical parameters between the two groups at baseline and follow up to evaluate the risk factors for MDRD-GFR of less than 60 mL/min per 1.73 m2 in kidney donors.
RESULTS
The CKD-GFR group was significantly older than the normal group at baseline (47 +/- 12 vs 41 +/- 11 years old, P = 0.02). Hypertension was more prevalent in the CKD-GFR group at baseline (15% vs 2%, P = 0.005). Binary logistic regression analysis showed that age (Odds ratio (OR) 1.06, 95% confidence interval (CI) 1.01-1.10) and hypertension (OR 7.91, 95% CI 1.13-55.2) at baseline were independent risk factors for MDRD-GFR of less than 60 mL/min per 1.73 m2. At final follow up, the prevalence rates of hypertension (31% vs 8%, P = 0.006) and proteinuria (15% vs 0%, P = 0.003) were significantly higher in the CKD-GFR group.
CONCLUSION
Older kidney donors and those with hypertension were significantly more likely to have a MDRD-GFR of less than 60 mL/min per 1.73 m2.
背景
尽管先前的多项研究报告称肾供体出现不良反应的风险并未增加，但仍有一些供体发展为慢性肾脏病（CKD）。我们回顾性评估了肾供体中根据简化版肾脏病饮食改良（MDRD）公式计算的估计肾小球滤过率（GFR）[MDRD-GFR]低于60 mL/（min·1.73 m²）的危险因素。
方法
在1990年6月27日至2001年4月30日期间接受开放性供肾切除术的756例个体中，104例有50个月或更长时间的随访记录。根据最后一次随访时的MDRD-GFR是否为60 mL/（min·1.73 m²），将这些个体分为正常组（n = 78）和CKD-GFR组（n = 26）。我们比较了两组在基线和随访时的几个临床参数，以评估肾供体中MDRD-GFR低于60 mL/（min·1.73 m²）的危险因素。
结果
CKD-GFR组在基线时的年龄显著大于正常组（47±12岁 vs 41±11岁，P = 0.02）。CKD-GFR组在基线时高血压更为普遍（15% vs 2%，P = 0.005）。二元逻辑回归分析显示，基线时的年龄（比值比[OR] 1.06，95%置信区间[CI] 1.01 - 1.10）和高血压（OR 7.91，95% CI 1.13 - 55.2）是MDRD-GFR低于60 mL/（min·1.73 m²）的独立危险因素。在最后一次随访时，CKD-GFR组的高血压患病率（31% vs 8%，P = 0.006）和蛋白尿患病率（15% vs 0%，P = 0.003）显著更高。
结论
年龄较大的肾供体和患有高血压的肾供体发生MDRD-GFR低于60 mL/（min·1.73 m²）的可能性显著更高。
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