Qiu Wenxian, Jiang Yan, Wu Jianyong, Huang Hongfeng, Xie Wenqing, Xie Xishao, Chen Jianghua, Peng Wenhan
Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Am J Nephrol. 2017;45(1):82-88. doi: 10.1159/000453078. Epub 2016 Dec 2.
Simple renal cysts may be an early marker of renal disease. We investigated whether simple cysts in donor kidney are associated with the decline of allograft function in living donor kidney transplantation.
We retrospectively reviewed records of donors and recipients from 716 living donor kidney transplants performed between April 2007 and April 2015 in our hospital. Ninety-one donors with renal cysts and 64 recipients with cysts in donor kidney were noted. We compared these 64 cases to 128 no cyst-bearing controls matched for the donor gender, recipient gender, donor baseline serum creatinine (sCr), donor/recipient body surface area ratio, donor age, recipient age and the date of kidney transplantation in turn.
The presence of cysts was interrelated with age, gender and renal function independently in donors. Pathological findings of time-zero biopsy revealed that donor kidney harboring cysts existed more glomerular sclerosis compared with no cyst-bearing controls (p = 0.040). The estimating glomerular filtration rate levels of recipients were 80.82 ± 26.61 vs. 88.21 ± 23.12, 66.95 ± 17.42 vs. 72.15 ± 16.42 and 60.92 ± 22.17 vs. 68.72 ± 14.43 ml/min· 1.73 m2 in cyst-bearing and no cyst-bearing group on day 7, month 6 and year 5, respectively, after surgery (p < 0.05). The mean sCr were 112.14 ± 48.32 vs. 98.75 ± 29.71 and 126.28 ± 42.32 vs. 115.05 ± 26.35 μmol/l on the 7th day and a half year after transplant, respectively (p < 0.05). The 2 groups did not significantly differ in terms of the other characteristics.
Simple cysts in donor kidney can influence the early and long-term allograft function. In living donor transplantation, kidney presenting cysts should be considered carefully at the time of donor selection.
单纯性肾囊肿可能是肾脏疾病的早期标志物。我们研究了供体肾中的单纯性囊肿是否与活体供肾移植中移植肾功能的下降有关。
我们回顾性分析了2007年4月至2015年4月在我院进行的716例活体供肾移植的供体和受体记录。记录了91例有肾囊肿的供体和64例供体肾中有囊肿的受体。我们将这64例病例依次与128例无囊肿对照进行比较,这些对照在供体性别、受体性别、供体基线血清肌酐(sCr)、供体/受体体表面积比、供体年龄、受体年龄和肾移植日期方面进行匹配。
供体中囊肿的存在与年龄、性别和肾功能独立相关。零时活检的病理结果显示,与无囊肿对照相比,有囊肿的供体肾存在更多的肾小球硬化(p = 0.040)。术后第7天、第6个月和第5年,有囊肿组和无囊肿组受体的估计肾小球滤过率水平分别为80.82±26.61 vs. 88.21±23.12、66.95±17.42 vs. 72.15±16.42和60.92±22.17 vs. 68.72±14.43 ml/min·1.73 m2(p < 0.05)。移植后第7天和半年时,两组的平均sCr分别为112.14±48.32 vs. 98.75±29.71和126.28±42.32 vs. 115.05±26.35 μmol/l(p < 0.05)。两组在其他特征方面无显著差异。
供体肾中的单纯性囊肿可影响移植肾的早期和长期功能。在活体供体移植中,选择供体时应仔细考虑有囊肿的肾脏。