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伊班膦酸钠抑制单核细胞-巨噬细胞对肾移植后移植物功能和存活的影响:一项为期15年的单中心随访研究

Impact of monocyte-macrophage inhibition by ibandronate on graft function and survival after kidney transplantation: a single-centre follow-up study over 15 years.

作者信息

Tillmann Frank-Peter, Grotz Wolfgang, Rump Lars Christian, Pisarski Przemyslaw

机构信息

Klinik für Nephrologie, Heinrich Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.

Klinik für Innere Medizin II, Alfried Krupp Krankenhaus Rüttenscheid, Alfried-Krupp-Straße 21, 45131, Essen, Germany.

出版信息

Clin Exp Nephrol. 2018 Apr;22(2):474-480. doi: 10.1007/s10157-017-1470-1. Epub 2017 Aug 30.

Abstract

BACKGROUND

The aim of this study was to evaluate the effect of ibandronate administration on long-term graft function and graft survival after successful renal transplantation.

METHODS

Seventy-two renal transplant recipients (36 patients each in the treatment and control group) were included and followed over a 15-year period. Data on graft function and death-censored transplant outcome were recorded at 1, 5, 10, and 15 years.

RESULTS

Death-censored Kaplan-Meier analysis showed significantly improved graft survival of the treatment group (p = 0.026), whereas Cox regression analysis showed that ibandronate was positively associated with improved transplant survival (p = 0.028, hazard ratio 0.24, 95% confidence interval 0.07-0.86). Although general linear modelling did not indicate that ibandronate had a significant effect on transplant function (calculated using the estimated glomerular filtration rate according to Chronic Kidney Disease Epidemiology Collaboration equation) over the entire 15-year period (p = 0.650), there was a tendency towards improved graft function 1-year post-transplantion (p = 0.056).

CONCLUSIONS

Ibandronate treatment within the first year of transplantation resulted in a trend towards better graft function within the first few year post-transplant, and was associated with increased transplant survival at long-term follow-up.

摘要

背景

本研究旨在评估伊班膦酸钠给药对肾移植成功后的长期移植肾功能和移植肾存活的影响。

方法

纳入72例肾移植受者(治疗组和对照组各36例),并进行了15年的随访。在1年、5年、10年和15年时记录移植肾功能和死亡删失的移植结局数据。

结果

死亡删失的Kaplan-Meier分析显示治疗组的移植肾存活显著改善(p = 0.026),而Cox回归分析显示伊班膦酸钠与移植存活改善呈正相关(p = 0.028,风险比0.24,95%置信区间0.07 - 0.86)。尽管广义线性模型未表明伊班膦酸钠在整个15年期间对移植肾功能(根据慢性肾脏病流行病学协作组方程使用估计的肾小球滤过率计算)有显著影响(p = 0.650),但移植后1年有移植肾功能改善的趋势(p = 0.056)。

结论

移植后第一年进行伊班膦酸钠治疗在移植后的头几年有移植肾功能改善的趋势,并且在长期随访中与移植存活增加相关。

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