Murray Eleanor C, McMillan Margaret
Renal ST4 (LAT), Glasgow Renal and Transplant Unit, Western Infirmary, UK
Consultant Renal Physician, Glasgow Renal and Transplant Unit, Western Infirmary, UK.
Scott Med J. 2015 Feb;60(1):32-6. doi: 10.1177/0036933014563238. Epub 2014 Dec 4.
The prevalent population with established renal failure continues to grow.
Using the Renal Electronic Patient Record, we assess the long-term outcomes of the adult population in the West of Scotland who were awaiting kidney transplantation in 1988 (n = 219), and compare the demographics to the 2011 transplant waiting list (n = 409).
Comparing the 2011 transplant waiting list, there are now more patients, but they are older, more likely to be female, and are more likely to have diabetes as a cause of renal failure. Seventy-four percent received a transplant; of these, 41% of the transplants ultimately failed and the patient returned to dialysis; 39% of patients died with a functioning graft and 20% remain alive with continuing transplant function. Life expectancy for those with renal failure was less than 60 years, significantly lower than the general population, though 29% survived for 20 years, half of these with a functioning kidney transplant and half having returned to dialysis.
As survival with a transplant improves, attention is required to reduce the causes of mortality, in particular cardiovascular disease, and malignancy and infection associated with immunosuppression.
已确诊肾衰竭的患病人数持续增加。
利用肾脏电子病历，我们评估了1988年在苏格兰西部等待肾移植的成年人群（n = 219）的长期预后，并将其人口统计学特征与2011年的移植等待名单（n = 409）进行比较。
与2011年的移植等待名单相比，现在患者更多，但年龄更大，女性比例更高，且因糖尿病导致肾衰竭的可能性更大。74%的患者接受了移植；其中，41%的移植最终失败，患者重新开始透析；39%的患者在移植肾功能正常时死亡，20%的患者在移植功能持续的情况下仍存活。肾衰竭患者的预期寿命不到60岁，显著低于普通人群，不过29%的患者存活了20年，其中一半人肾移植功能正常，另一半人重新开始透析。
随着移植存活率的提高，需要关注降低死亡率的原因，特别是心血管疾病以及与免疫抑制相关的恶性肿瘤和感染。
