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肾移植受者肾功能结局的白蛋白尿预测

Albuminuria prediction of kidney function outcome in kidney transplant recipients.

作者信息

El Minshawy Osama, El-Bassuoni Eman

机构信息

Department of Medicine, School of Medicine, University of Tabuk, Tabuk, Saudi Arabia.

出版信息

Saudi J Kidney Dis Transpl. 2015 Mar;26(2):227-31. doi: 10.4103/1319-2442.152397.

Abstract

To investigate the association of albuminuria and kidney function outcome in kidney transplant recipients, we studied 161 kidney transplant recipients; 95 (59%) of them were males and the mean age of the patients was 46 ± 13 years (range 18-70 years). All the patients received allografts from living related kidney donors. The mean body mass index of the patients was 25 ± 4 kg/m 2 . Forty (25%) patients were diabetic and 72 (45%) patients were hypertensive. All the patients had glomerular filtration rate (iGFR) determination by ( 99m Tc-DTPA) clearance and albumiuria was assessed using the first voided morning urine samples. According to the results of albuminuria, the patients were subdivided into three groups: One group of 90 (56%) patients with normoalbuminuria (<30 mg albumin/g. creatinine), a second group of 52 (32%) patients with microalbuminuria (30-300 mg albumin/g. creatinine) and a third group of 19 (12%) patients with macroalbuminuria (>300 mg/g. creatinine). There was a significant increase in the time post transplantation in the patients with macroalbumiuria in comparison with microalbuminuria and normoalbuminuria (90 ± 28, 60 ± 22 and 18 ± 6 months, respectively), P <0.05. There was a significant decrease of iGFR in the macroalbumiuria group as compared with the microalbumiuria and normoalbuminuria groups (57 ± 24, 74 ± 20 and 74 ± 28 mL/min/1.73 m 2 , respectively), P <0.05. We conclude that there was an association between albuminuria and the status of the renal function in our transplant population, which may reflect renal injury due to proteinuria. Prospective studies are warranted to evaluate the effect of albuminuria on the prognosis of the kidney allografts.

摘要

为了研究肾移植受者中蛋白尿与肾功能结局的关联,我们对161名肾移植受者进行了研究;其中95名(59%)为男性,患者的平均年龄为46±13岁(范围18 - 70岁)。所有患者均接受来自活体亲属肾供体的同种异体肾移植。患者的平均体重指数为25±4kg/m²。40名(25%)患者患有糖尿病,72名(45%)患者患有高血压。所有患者均通过(99mTc - DTPA)清除率测定肾小球滤过率(iGFR),并使用晨尿首次排尿样本评估蛋白尿情况。根据蛋白尿结果,患者被分为三组:一组90名(56%)为正常蛋白尿患者(<30mg白蛋白/g肌酐),第二组52名(32%)为微量蛋白尿患者(30 - 300mg白蛋白/g肌酐),第三组19名(12%)为大量蛋白尿患者(>300mg/g肌酐)。与微量蛋白尿和正常蛋白尿患者相比,大量蛋白尿患者移植后的时间显著增加(分别为90±28个月、60±22个月和18±6个月),P<0.05。与微量蛋白尿和正常蛋白尿组相比,大量蛋白尿组的iGFR显著降低(分别为57±24、74±20和74±28mL/min/1.73m²),P<0.05。我们得出结论,在我们的移植人群中,蛋白尿与肾功能状态之间存在关联,这可能反映了蛋白尿导致的肾损伤。有必要进行前瞻性研究以评估蛋白尿对同种异体肾移植预后的影响。

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