Han Xiao, Lim Joel Yu Ming, Raman Lata, Tai Bee Choo, Kaur Hersharan, Goh Angeline Ting Hui, Vathsala Anantharaman, Tiong Ho Yee
Department of Urology, National University Hospital, National University Health System, Singapore, Singapore.
Saw Swee Hock School of Public Health, National University Hospital, National University Health System, Singapore, Singapore.
Clin Transplant. 2017 Mar;31(3). doi: 10.1111/ctr.12910. Epub 2017 Feb 20.
To evaluate the health impact of nephrectomy on living kidney donors (LKDs) by comparing the health-related quality of life (HrQOL) scores measured by Short Form-36 (SF36) between those with and without postdonation renal function impairment (PRFI).
Eighty-two LKDs (47 females, mean age=50.2±11.2 years) were prospectively recruited to participate in a SF-36 HrQOL survey. Chart review, individual baseline, and postoperative renal function (eGFR) was determined using the Modification of Diet in Renal Disease formula. PRFI was defined as eGFR<60 mL/min/1.73 m or proteinuria. Mean SF-36 domain scores were compared between those with and without PRFI.
After a median follow-up of 5.7 years, the prevalence of postdonation comorbidities was 29.3% (n=24) PRFI, 25.6% (n=21) hypertension, 6.1% (n=5) diabetes, and 3.7% (n=3) heart disease, and no LKDs developed end-stage renal disease. Mean eGFR before and after donor nephrectomy was 95.5±23.4 and 71.0±17.3 mL/min/1.73 m (P<.01). Mean SF-36 scores of LKDs were not significantly different between those with and without PRFI in all the domains (all P>.05). Similarly, the proportion of LKDs with PRFI did not differ significantly between the patients with SF-36 domain scores above and below the published reference values.
Nephrectomy-induced PRFI may not have a significant impact on the HrQOL of the LKD population with a low proportion of other major comorbidities such as diabetes and ischemic heart disease.
通过比较有和没有捐赠后肾功能损害（PRFI）的活体肾供者（LKDs）的简短健康调查问卷36项（SF36）测量的健康相关生活质量（HrQOL）得分，评估肾切除术对LKDs健康的影响。
前瞻性招募82名LKDs（47名女性，平均年龄=50.2±11.2岁）参与SF-36 HrQOL调查。通过病历审查确定个体基线，并使用肾脏病饮食改良公式测定术后肾功能（eGFR）。PRFI定义为eGFR<60 mL/min/1.73 m²或蛋白尿。比较有和没有PRFI者的平均SF-36领域得分。
中位随访5.7年后，捐赠后合并症的患病率为PRFI 29.3%（n=24）、高血压25.6%（n=21）、糖尿病6.1%（n=5）和心脏病3.7%（n=3），没有LKDs发展为终末期肾病。供肾切除术前和术后的平均eGFR分别为95.5±23.4和71.0±17.3 mL/min/1.73 m²（P<.01）。在所有领域中，有和没有PRFI的LKDs的平均SF-36得分没有显著差异（所有P>.05）。同样，SF-36领域得分高于和低于已发表参考值的患者中，有PRFI的LKDs比例没有显著差异。
肾切除术引起的PRFI可能对其他主要合并症（如糖尿病和缺血性心脏病）比例较低的LKDs人群的HrQOL没有显著影响。
