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常染色体显性多囊肾病与肾移植:单中心经验

Autosomal-dominant polycystic kidney disease and kidney transplantation: experience of a single center.

作者信息

Gonçalves S, Guerra J, Santana A, Abreu F, Mil-Homens C, Gomes da Costa A

机构信息

Serviço de Nefrologia e Transplantação Renal, Hospital de Santa Maria, Lisboa, Portugal.

出版信息

Transplant Proc. 2009 Apr;41(3):887-90. doi: 10.1016/j.transproceed.2009.01.069.

Abstract

BACKGROUND

Autosomal dominant polycystic kidney disease (ADPKD) is a hereditary disease that frequently leads to end-stage renal disease and is a common indication for kidney transplantation. We sought to evaluate the demographic characteristics, graft and patient survival, and some posttransplantation complications among ADPKD recipients.

METHODS

This retrospective study included 445 renal transplant recipients, among whom 48 had ADPKD. We excluded patients with pretransplantation diabetes mellitus. We evaluated patient and graft survivals as well as posttransplantation complications.

RESULTS

There was no difference between the 2 groups with respect to demographic or transplant characteristics, except for older age among the ADPKD group (51.2 +/- 8.6 years vs 44 +/- 13.1 years; P < .001). We also observed no significant difference with regard to immediate graft function, immunological graft, or patient survival. Although not significant, there was a lower incidence of proteinuria and a greater number of acute rejections among ADPKD patients. As for posttransplantation complications, there was no difference regarding the prevalence of hypertension, but there was more erythrocytosis among the ADPKD group. The incidence of posttransplantation diabetes mellitus was significantly greater in ADPKD patients (33.3% vs 17.1%; P = .009), and remained significant after adjusting for confounding variables by multivariate analysis with an adjusted odds ratio of 2.3 (95% confidence interval, 1.008-5.136; P = .048).

CONCLUSION

Our results suggested that ADPKD patients display a greater incidence of diabetes mellitus posttransplantation; ADPKD emerged as an independent predictor for this complication.

摘要

背景

常染色体显性遗传性多囊肾病(ADPKD)是一种遗传性疾病,常导致终末期肾病,是肾移植的常见适应证。我们旨在评估ADPKD肾移植受者的人口统计学特征、移植物和患者生存率以及一些移植后并发症。

方法

这项回顾性研究纳入了445例肾移植受者,其中48例患有ADPKD。我们排除了移植前患有糖尿病的患者。我们评估了患者和移植物的生存率以及移植后并发症。

结果

两组在人口统计学或移植特征方面无差异,但ADPKD组年龄较大(51.2±8.6岁对44±13.1岁;P<.001)。我们还观察到在即刻移植物功能、免疫性移植物或患者生存率方面无显著差异。虽然不显著,但ADPKD患者蛋白尿的发生率较低,急性排斥反应的次数较多。至于移植后并发症,高血压的患病率无差异,但ADPKD组红细胞增多症更多。ADPKD患者移植后糖尿病 mellitus的发生率显著更高(33.3%对17.1%;P=.009),在通过多变量分析调整混杂变量后仍然显著,调整后的优势比为2.3(95%置信区间,1.008-5.136;P=.048)。

结论

我们的结果表明,ADPKD患者移植后糖尿病的发生率更高;ADPKD是这种并发症的独立预测因素。

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