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肾移植后的糖尿病。

Diabetes after kidney donation.

机构信息

Department of Medicine, University of Minnesota, Minneapolis, MN, USA.

出版信息

Am J Transplant. 2010 Feb;10(2):331-7. doi: 10.1111/j.1600-6143.2009.02944.x. Epub 2009 Dec 23.

Abstract

Kidney donors, similar to the general population, are at risk for development of type 2 diabetes mellitus (T2DM). The course of donors who develop T2DM has not been studied. We surveyed 3777 kidney donors regarding the development of T2DM. Of the 2954 who responded, 154 developed T2DM 17.7 +/- 9.0 years after donation. The multivariable risk of development of T2DM was associated with type 1 DM in the recipient, male gender and body mass index >30 kg/m(2) at time of donation. Compared to age, gender, duration after donation and body mass index (BMI)-matched non-diabetic donor controls; diabetic donors were more likely to have hypertension (70.8% vs. 36.2%, p = 0.005), proteinuria (18.8% vs. 3.9%, p < 0.0001) but had a similar serum creatinine. eGFR change after T2DM development was -0.80 +/- 0.94 mL/min/year, -0.70 +/- 0.86 in nondiabetic donors with similar duration after donation and -0.61 +/- 0.76 mL/min/year in age, gender, BMI and duration after donation matched nondiabetic donor controls. These preliminary and short-term data demonstrate that factors associated with T2DM in kidney donors are similar to those in the general population and donors screened carefully at the time of donation do not appear to have an acceleration of diabetic kidney disease.

摘要

与一般人群一样,肾脏捐献者也有发生 2 型糖尿病(T2DM)的风险。尚未研究发生 T2DM 的供体的病程。我们调查了 3777 名肾脏捐献者 T2DM 的发病情况。在 2954 名有反应的人中,有 154 人在捐赠后 17.7 +/- 9.0 年内发生了 T2DM。T2DM 发病的多变量风险与受者 1 型糖尿病、男性和捐赠时体重指数(BMI)>30 kg/m(2)有关。与年龄、性别、捐赠后时间和 BMI(BMI)匹配的非糖尿病供体对照相比;糖尿病供体更有可能患有高血压(70.8%比 36.2%,p = 0.005)、蛋白尿(18.8%比 3.9%,p < 0.0001),但血清肌酐相似。T2DM 发病后 eGFR 变化为-0.80 +/- 0.94 mL/min/年,与捐赠后时间相似的非糖尿病供体对照中为-0.70 +/- 0.86 mL/min/年,与年龄、性别、BMI 和捐赠后时间匹配的非糖尿病供体对照中为-0.61 +/- 0.76 mL/min/年。这些初步和短期数据表明,与一般人群相比,与肾脏供体发生 T2DM 相关的因素相似,在捐赠时经过仔细筛选的供体似乎没有加速糖尿病肾病的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b5/3565834/a96e1e302130/nihms435806f1.jpg

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本文引用的文献

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Appraisal of GFR-estimating equations following kidney donation.肾移植后肾小球滤过率估算方程的评估。
Am J Kidney Dis. 2009 Jun;53(6):1050-8. doi: 10.1053/j.ajkd.2009.01.264. Epub 2009 Apr 25.
2
Long-term consequences of kidney donation.肾脏捐献的长期后果。
N Engl J Med. 2009 Jan 29;360(5):459-69. doi: 10.1056/NEJMoa0804883.

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