移植前骨矿物质代谢的变化不影响肾移植的初始进程。

[Changes in the pre-transplant bone-mineral metabolism do not affect the initial progress of the renal graft].

作者信息

Rodrigo Calabia E, Ruiz San Millán J C, Gago M, Ruiz Criado J, Piñera Haces C, Fernández Fresnedo G, Palomar R, Gómez Alamillo C, Martín de Francisco A L, Arias M

机构信息

Servicio de Nefrología, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.

出版信息

Nefrologia. 2009;29(2):143-9. doi: 10.3265/Nefrologia.2009.29.2.5006.en.full.

DOI:10.3265/Nefrologia.2009.29.2.5006.en.full

PMID:19396320

Abstract

BACKGROUND

Abnormalities in serum calcium, phosphate, and Parathyroid Hormone (PTH) concentrations are common in patients with chronic kidney disease and have been associated with increased morbidity and mortality. One of the most common problems in the first weeks after renal transplantation is Delayed Graft Function (DGF). There are several well-known risk factors for DGF development, but the role of calcium phosphate-PTH homeostasis as a risk factor for early graft dysfunction is controversial. This issue was addressed in the current study.

METHODS

Pretransplant PTH, calcium and phosphate values were gathered in 449 patients that received a renal transplant in our center between 1994 and 2007. Other variables expected to influence the risk for delayed graft function were included from the clinical charts.

RESULTS

The incidence of DGF was 27.3%. DGF development was significantly associated with recipient age, type and need of renal replacement therapy, peak panel reactive antibodies, transfusion number and donor age. There were no significant differences in the mean pretransplant values of calcium (9.4 +/- 1.0 vs. 9.5 +/- 0.9 mg/dl, p = 0.667), phosphate (5.7 +/- 1.8 vs. 5.5 +/- 1.5 mg/dl, p = 0.457), calcium-phosphate product (53.5 +/- 17.2 vs. 51.8 +/- 14.6 mg(2)/dl(2), p = 0.413) and PTH (315 +/- 312 vs. 340 +/- 350 pg/ml, p = 0.530) between patients with and without DGF.

CONCLUSIONS

In our study population pretransplant serum PTH, calcium and phosphorus levels have no influence on the risk for DGF.

摘要

背景

血清钙、磷及甲状旁腺激素（PTH）浓度异常在慢性肾脏病患者中很常见，且与发病率和死亡率增加相关。肾移植后最初几周最常见的问题之一是移植肾功能延迟恢复（DGF）。DGF发生有几个众所周知的危险因素，但钙磷 - PTH内稳态作为早期移植肾功能障碍危险因素的作用存在争议。本研究探讨了这个问题。

方法

收集了1994年至2007年在我们中心接受肾移植的449例患者移植前的PTH、钙和磷值。从临床病历中纳入了其他预期会影响移植肾功能延迟风险的变量。

结果

DGF的发生率为27.3%。DGF的发生与受者年龄、肾脏替代治疗的类型和需求、群体反应性抗体峰值、输血次数及供者年龄显著相关。发生DGF和未发生DGF的患者之间，移植前钙（9.4±1.0 vs. 9.5±0.9mg/dl，p = 0.667）、磷（5.7±1.8 vs. 5.5±1.5mg/dl，p = 0.457）、钙磷乘积（53.5±17.2 vs. 51.8±14.6mg²/dl²，p = 0.413）和PTH（315±312 vs. 340±350pg/ml，p = 0.530）的平均移植前值无显著差异。