Berglund Danielle, MacDonald David, Jackson Scott, Spong Richard, Issa Naim, Kukla Aleksandra, Reule Scott, Weber Marc, Matas Arthur J, Ibrahim Hassan N
Department of Surgery, University of Minnesota, Minneapolis, MN, USA.
Clin Transplant. 2014 Mar;28(3):361-7. doi: 10.1111/ctr.12321. Epub 2014 Feb 19.
Low birthweight is linked to hypertension, chronic kidney disease and even end-stage renal disease. We hypothesized that living kidney donors born with lower birthweight may be at increased risk of hypertension, albuminuria, or reduced GFR beyond what is typical following uninephrectomy. Two hundred fifty-seven living kidney donors who donated at the University of Minnesota between 1967 and 2005 underwent iohexol GFR and urinary albumin excretion measurements. Predictors of iohexol GFR <60 mL/min/1.73 m(2), albuminuria, and hypertension were examined using logistic regression. Predictors examined include age at GFR measurement, time since donation, BMI, gender, serum creatinine level (at donation and GFR measurement), systolic and diastolic blood pressure, race, and birthweight. The latter was obtained through self-report and verified through birth certificates and family members. Older age, higher BMI, and time from donation were associated with reduced GFR. Older age and higher BMI were also associated with hypertension. Birthweight was not associated with GFR <60 mL/min/1.73 m(2): OR=0.70, 95% CI (0.28, 1.74), p = 0.45 or hypertension: OR=0.92, 95% CI (0.46, 1.84), p = 0.82 but was associated with albuminuria: OR=0.37, 95% CI (0.15, 0.92), p = 0.03. These data further strengthen the link between low birthweight and potential adverse renal outcomes.
低出生体重与高血压、慢性肾病甚至终末期肾病有关。我们推测，出生时体重较低的活体肾供者发生高血压、蛋白尿或肾小球滤过率（GFR）降低的风险可能高于单纯肾切除术后的典型风险。1967年至2005年间在明尼苏达大学进行肾脏捐献的257名活体肾供者接受了碘海醇GFR和尿白蛋白排泄量测量。采用逻辑回归分析碘海醇GFR<60 mL/min/1.73 m²、蛋白尿和高血压的预测因素。所检测的预测因素包括GFR测量时的年龄、捐献后的时间、体重指数（BMI）、性别、血清肌酐水平（捐献时和GFR测量时）、收缩压和舒张压、种族以及出生体重。后者通过自我报告获得，并通过出生证明和家庭成员进行核实。年龄较大、BMI较高以及捐献后的时间与GFR降低有关。年龄较大和BMI较高也与高血压有关。出生体重与GFR<60 mL/min/1.73 m²无关：比值比（OR）=0.70，95%置信区间（CI）（0.28，1.74），p = 0.45；与高血压也无关：OR=0.92，95% CI（0.46，1.84），p = 0.82，但与蛋白尿有关：OR=0.37, 95% CI（0.15, 0.92），p = 0.03。这些数据进一步加强了低出生体重与潜在不良肾脏结局之间的联系。
