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2型糖尿病肾病患者肾移植的结局:单中心经验

Outcome of renal transplantation in patients with type 2 diabetic nephropathy: a single-center experience.

作者信息

Noguchi H, Kitada H, Kaku K, Kurihara K, Kawanami S, Tsuchimoto A, Masutani K, Nakamura U, Tanaka M

机构信息

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

出版信息

Transplant Proc. 2015 Apr;47(3):608-11. doi: 10.1016/j.transproceed.2014.12.047. Epub 2015 Mar 26.

Abstract

BACKGROUND

Renal transplantation has been established as a treatment for end-stage renal disease (ESRD) due to diabetic nephropathy. However, few studies have focused on the outcome after renal transplantation in patients with ESRD and type 2 diabetic nephropathy. To investigate the effect of renal transplantation on ESRD with type 2 diabetic nephropathy, we retrospectively analyzed patients who received renal transplantation at our facility. This study aimed to compare the outcome of renal transplantation for type 2 diabetic nephropathy with that for nondiabetic nephropathy.

METHODS

We studied 290 adult patients, including 65 with type 2 diabetic nephropathy (DM group) and 225 with nondiabetic nephropathy (NDM group), who underwent living-donor renal transplantation at our facility from February 2008 to March 2013. We compared the 2 groups retrospectively.

RESULTS

In the DM and NDM groups, the 5-year patient survival rates were 96.6% and 98.7%, and the 5-year graft survival rates were 96.8% and 98.0%, respectively, with no significant differences between the groups. There were no significant differences in the rates of surgical complications, rejection, and infection. The cumulative incidence of postoperative cardiovascular events was higher in the DM group than in the NDM group (8.5% vs 0.49% at 5 years; P = .002).

CONCLUSIONS

Patient and graft survival rates after renal transplantation for type 2 diabetic nephropathy are not inferior to those for recipients without diabetic nephropathy. Considering the poor prognosis of patients with diabetic nephropathy on dialysis, renal transplantation can provide significant benefits for these patients.

摘要

背景

肾移植已被确立为治疗糖尿病肾病所致终末期肾病(ESRD)的一种方法。然而,很少有研究关注ESRD合并2型糖尿病肾病患者肾移植后的结局。为了研究肾移植对2型糖尿病肾病所致ESRD的影响,我们对在我院接受肾移植的患者进行了回顾性分析。本研究旨在比较2型糖尿病肾病患者与非糖尿病肾病患者肾移植的结局。

方法

我们研究了290例成年患者,其中包括65例2型糖尿病肾病患者(糖尿病组)和225例非糖尿病肾病患者(非糖尿病组),这些患者于2008年2月至2013年3月在我院接受了活体供肾肾移植。我们对这两组患者进行了回顾性比较。

结果

在糖尿病组和非糖尿病组中,5年患者生存率分别为96.6%和98.7%,5年移植肾生存率分别为96.8%和98.0%,两组之间无显著差异。手术并发症、排斥反应和感染发生率也无显著差异。糖尿病组术后心血管事件的累积发生率高于非糖尿病组(5年时分别为8.5%和0.49%;P = 0.002)。

结论

2型糖尿病肾病患者肾移植后的患者生存率和移植肾生存率并不低于无糖尿病肾病的受者。考虑到糖尿病肾病患者透析预后较差,肾移植可为这些患者带来显著益处。

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