Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.
Clin Exp Nephrol. 2011 Aug;15(4):514-21. doi: 10.1007/s10157-011-0441-1. Epub 2011 Apr 19.
Mortality and renal or cardiovascular prognosis in living kidney donors (LKDs) has been reported to be as same as the general population; however, it is known that the prevalence of hypertension, albuminuria and metabolic syndrome increases after donation. At present, data from Japanese donors are scarce and as a result the actual medical status of LKDs remains unclear. To evaluate cardiovascular disease (CVD) risk factors in Japanese LKDs, we conducted a cross-sectional study on LKDs at our tertiary care hospital and clinic.
Thirty-six out of 63 LKDs who underwent kidney donation at the kidney disease center of the St. Marianna University Hospital were enrolled. The kidney function, albuminuria, and CVD risk factors including hypertension, dyslipidemia, hyperuricemia, glucose intolerance (GI) and obesity were cross-sectionally investigated.
The kidney function by inulin clearance was 55.2 ± 10.3 ml/min/1.73 m(2) on average, indicating that 63.9% of LKDs were categorized into chronic kidney disease (CKD) stage 3 after donation. Albuminuria developed in 16.7%. Blood pressure (BP) was not elevated after donation, but ambulatory BP monitoring revealed that 39.4% of LKDs were categorized as having non-dipper type BP. GI was shown in 25% of LKDs. Prevalence of dyslipidemia and hyperuricemia were 41.7% and 27.8%, respectively. Body mass index was not significantly changed after donation. Seven LKDs (19.4%) were diagnosed with metabolic syndrome.
Many Japanese LKDs were experiencing decreased kidney function corresponding to CKD stage 3. They also had a significant but not lower prevalence of albuminuria and CVD risk compared to the general Japanese population. LKDs should be followed closely with special attention to the management of renal and CVD risk factors.
活体供肾者（LKD）的死亡率和肾脏或心血管预后被报道与普通人群相同；然而，众所周知，供肾后高血压、白蛋白尿和代谢综合征的患病率增加。目前，来自日本供者的数据很少，因此 LKD 的实际医疗状况仍不清楚。为了评估日本 LKD 的心血管疾病（CVD）危险因素，我们在我们的三级保健医院和诊所对 LKD 进行了横断面研究。
从圣玛丽安娜大学医院肾脏病中心接受肾脏捐献的 63 名 LKD 中选择了 36 名。对肾脏功能、白蛋白尿以及包括高血压、血脂异常、高尿酸血症、葡萄糖耐量（GI）受损和肥胖在内的 CVD 危险因素进行了横断面调查。
平均而言，通过菊粉清除率的肾功能为 55.2±10.3ml/min/1.73m²，表明 63.9%的 LKD 在捐献后被归类为慢性肾脏病（CKD）3 期。16.7%的 LKD 出现白蛋白尿。供肾后血压（BP）不升高，但动态血压监测显示 39.4%的 LKD 被归类为非杓型血压。25%的 LKD 出现 GI 受损。血脂异常和高尿酸血症的患病率分别为 41.7%和 27.8%。供肾后体重指数无明显变化。7 名 LKD（19.4%）被诊断为代谢综合征。
许多日本 LKD 的肾脏功能下降，符合 CKD 3 期。与普通日本人群相比，他们的白蛋白尿和 CVD 危险因素的发生率也显著增加，但没有降低。LKD 应密切随访，并特别注意肾脏和 CVD 危险因素的管理。
