Meyer Käthe B, Hartmann Anders, Mjøen Geir, Andersen Marit H
Department of Transplantation, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Institute of Clinical Medicine University of Oslo, Oslo, Norway.
Ann Transplant. 2017 Mar 21;22:148-155. doi: 10.12659/aot.902330.
BACKGROUND Long-term consequences of donor nephrectomy might be reduced kidney function, increased risk for cardiovascular disease, impaired quality of life, and fatigue. Few studies have investigated associations between clinical and self-reported outcomes in a long-term perspective. Thus, we aimed to investigate relationships between clinical, self-reported, and donation-specific outcomes in a nationwide cohort. MATERIAL AND METHODS We conducted a prospective follow-up study and assessed pre- and post-donation data from 202 donors who donated in 2001-2004. During 2012-2013, data on donors' self-reported (quality of life and fatigue) and donor-specific outcomes were collected. We performed linear regression for each component score of the generic instrument Short-Form, SF36v2, measuring quality of life, and the 5 domains of fatigue. Clinical parameters tested as independent variables were medical treatment of hyperlipidemia or hypertension, current smoking status, BMI, hemoglobin, and eGFR. Data were adjusted for age and gender. RESULTS Approximately 10 years after donation, 67 donors were hypertensive and 54 donors had eGFR <60 ml/min/1.73 m². Mean increase in plasma creatinine was 16.6 µmol/l (SD=16.3). None of the clinical parameters were significant predictors for QoL. Female gender was significantly associated with general fatigue. There was a significant difference in perception of recognition from health personnel between donors with hypertension and donors without hypertension. CONCLUSIONS Our results show no associations between clinical and self-reported outcomes. However, we found a significant relationship between hypertension and donation-specific outcomes. Hypertension or reduced kidney function was identified in a minority of the donors. The increased risk for fatigue among female donors needs more investigation.
供体肾切除术的长期后果可能包括肾功能下降、心血管疾病风险增加、生活质量受损和疲劳。很少有研究从长期角度调查临床和自我报告结果之间的关联。因此，我们旨在调查全国队列中临床、自我报告和与捐赠相关的结果之间的关系。
我们进行了一项前瞻性随访研究，评估了2001年至2004年期间捐赠的202名供体的捐赠前和捐赠后数据。在2012年至2013年期间，收集了供体自我报告的（生活质量和疲劳）以及与捐赠相关的结果数据。我们对测量生活质量的通用工具简表36（SF36v2）的每个成分得分以及疲劳的5个领域进行了线性回归分析。作为自变量测试的临床参数包括高脂血症或高血压的药物治疗、当前吸烟状况、体重指数、血红蛋白和估算肾小球滤过率（eGFR）。数据根据年龄和性别进行了调整。
捐赠后约10年，67名供体患有高血压，54名供体的eGFR<60 ml/min/1.73 m²。血浆肌酐的平均增加量为16.6 µmol/l（标准差=16.3）。没有一个临床参数是生活质量的显著预测因素。女性性别与全身疲劳显著相关。患有高血压的供体和未患高血压的供体在对医护人员认可程度的感知上存在显著差异。
我们的结果显示临床和自我报告结果之间没有关联。然而，我们发现高血压与捐赠相关结果之间存在显著关系。少数供体出现了高血压或肾功能下降。女性供体中疲劳风险增加需要更多研究。
