移植前使用他汀类药物与肾移植受者移植肾功能延迟恢复的关系。

Association of pre-transplant statin use with delayed graft function in kidney transplant recipients.

机构信息

Queensland Renal Transplant Service, Princess Alexandra Hospital, Brisbane, Australia.

出版信息

BMC Nephrol. 2012 Sep 17;13:111. doi: 10.1186/1471-2369-13-111.

DOI:10.1186/1471-2369-13-111

PMID:22985048

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3507677/

Abstract

BACKGROUND

Administration of HMG-CoA reductase inhibitors (statins), prior to ischemia or prior to reperfusion has been shown to decrease ischemia-reperfusion renal injury in animal studies. It is unknown whether this protective effect is applicable to renal transplantation in humans. The aim of this study was to determine the relationship between prior statin use in renal transplant recipients and the subsequent risk of delayed graft function.

METHODS

All patients who underwent deceased or living donor renal transplantation at the Princess Alexandra Hospital between 1 July 2008 and 1 August 2010 were included in this retrospective, observational cohort study. Graft function was classified as immediate graft function (IGF), dialysis-requiring (D-DGF) and non-dialysis-requiring (ND-DGF) delayed graft function. The independent predictors of graft function were evaluated by multivariable logistic regression, adjusting for donor characteristics, recipient characteristics, HLA mismatch and ischaemic times.

RESULTS

Overall, of the 266 renal transplant recipients, 21% exhibited D-DGF, 39% had ND-DGF and 40% had IGF. Statin use prior to renal transplantation was not significantly associated with the risk of D-DGF (adjusted odds ratio [OR] 1.05, 95% CI 0.96 - 1.15, P = 0.28). This finding was not altered when D-DGF and ND-DGF were pooled together (OR 0.98; 95% CI 0.89-1.06, p = 0.56).

CONCLUSIONS

The present study did not show a significant, independent association between prior statin use in kidney transplant recipients and the occurrence of delayed graft function.

摘要

背景

在动物研究中，HMG-CoA 还原酶抑制剂（他汀类药物）的预先给药，无论是在缺血前还是再灌注前，都已被证明可以减少缺血再灌注肾损伤。但尚不清楚这种保护作用是否适用于人类的肾移植。本研究的目的是确定肾移植受者预先使用他汀类药物与随后发生延迟移植物功能障碍的风险之间的关系。

方法

本回顾性观察队列研究纳入了 2008 年 7 月 1 日至 2010 年 8 月 1 日期间在Princess Alexandra 医院接受已故或活体供体肾移植的所有患者。将移植物功能分为即刻移植物功能（IGF）、需要透析（D-DGF）和不需要透析（ND-DGF）的延迟移植物功能障碍。通过多变量逻辑回归，调整供体特征、受者特征、HLA 错配和缺血时间，评估移植物功能的独立预测因素。

结果

在总共 266 例肾移植受者中，21%表现为 D-DGF，39%表现为 ND-DGF，40%表现为 IGF。肾移植前使用他汀类药物与 D-DGF 的风险无显著相关性（调整后的优势比[OR]1.05，95%可信区间 0.96-1.15，P=0.28）。当 D-DGF 和 ND-DGF 合并在一起时，这一发现并没有改变（OR 0.98；95%可信区间 0.89-1.06，p=0.56）。