Vega Jorge, Lira Daniel, Medel Simón, Betancour Pablo, Goecke Helmuth, Carrasco Alejandra
Sección Nefrología, Servicio de Medicina Interna, Hospital Dr. Gustavo Fricke, Viña del Mar, Chile.
Rev Med Chil. 2012 Aug;140(8):990-8. doi: 10.4067/S0034-98872012000800004.
Patients with autosomal dominant polycystic kidney disease (ADPKD) have a better survival in chronic dialysis than patients with other etiologies of renal failure. It has been suggested that extra-renal manifestations of ADPKD may increase the odds of complications and mortality, if these patients are transplanted.
To determine whether survival and complications in transplanted patients with ADPKD are different from kidney graft recipients with other etiologies of renal failure.
Four hundred six patients with kidney transplantation were followed in three hospitals between 1976 and 2011 and 19 were carriers of ADPKD. The latter were matched by type of donor, gender, age and date of kidney transplant, with 38 graft recipients with other etiologies of renal failure.
Graft and patient 1, 5, 10 and 15 years survival were similar in both groups. Hospitalizations due to viral infections and sepsis were more common in patients with ADPKD. There were no differences in the rate of acute rejection, delayed graft function, cancer, gastrointestinal disorders and hospitalizations due to cardiovascular diseases. The frequency of graft loss due to death with a functioning kidney was similar between both groups.
Patient and graft survival in transplanted patients with ADPKD were similar to patients with other etiologies of renal failure. The rate and type of complications were similar between groups with the exception of hospitalizations due to sepsis and viral infections, which were more common in ADPKD patients.
与其他病因导致肾衰竭的患者相比,常染色体显性多囊肾病(ADPKD)患者在慢性透析中有更好的生存率。有人提出,如果这些患者接受移植,ADPKD的肾外表现可能会增加并发症和死亡的几率。
确定ADPKD移植患者的生存率和并发症是否与其他病因导致肾衰竭的肾移植受者不同。
1976年至2011年间,在三家医院对406例肾移植患者进行了随访,其中19例为ADPKD携带者。后者根据供体类型、性别、年龄和肾移植日期,与38例其他病因导致肾衰竭的移植受者进行匹配。
两组的移植肾和患者1年、5年、10年和15年生存率相似。ADPKD患者因病毒感染和败血症住院更为常见。急性排斥反应、移植肾功能延迟、癌症、胃肠道疾病和心血管疾病导致的住院率没有差异。两组因有功能肾死亡导致的移植肾丢失频率相似。
ADPKD移植患者的患者和移植肾生存率与其他病因导致肾衰竭的患者相似。除败血症和病毒感染导致的住院在ADPKD患者中更为常见外,两组的并发症发生率和类型相似。