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活体亲属肾供体肾功能的长期评估。

Long-term evaluation of kidney function in live-related kidney donors.

作者信息

Mehta Kalpana S, Swami Rudramani, Pajai Atim, Bhurke Sandip, Shirkande Abhishek, Jawle Sunil

机构信息

Department of Nephrology, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai, Maharashtra, India.

出版信息

Saudi J Kidney Dis Transpl. 2017 Sep-Oct;28(5):1041-1049. doi: 10.4103/1319-2442.215145.

Abstract

The consequences of live kidney donation on the donor health with main emphasis on postdonation blood pressure (BP), proteinuria, kidney size, and glomerular filtration rate (GFR) were evaluated. Twenty-five donors with minimum of six months postdonation duration were included in the study. Donor age at nephrectomy, duration postnephrectomy, systolic and diastolic BP measurement pre-and post-donation, postdonation, blood urea nitrogen, serum creatinine and 24-h proteinuria, blood sugar, two-dimensional echocardiogram were recorded. Kidney sizes pre-and post-donation were noted. GFR was calculated by chronic kidney disease epidemiology collaboration and modification of diet in renal disease formula and measured by diethylene triamine pentaacetic acid renogram in all donors pre-and post-donation. Twenty-one (84%) were female, and four (16%) were male. The mean age at donation was 46.24 ± 9.62 (28-65) years. Median duration postdonor nephrectomy was 26 (minimum 7 and maximum 228) months. There was a mean rise of 6.24 mm Hg in systolic and 4.20 mm Hg diastolic BP (P = 0.001). Remnant kidney size increased from 35.12 ± 6.80 to 42.32 ± 8.59 sq cm (P <0.0001). There was reduction of postdonation GFR from 94.50 ± 18.12 mL/min to 60.48 ± 14.32 mL/min after nephrectomy (P <0.0001). There was significant increase in remnant kidney GFR from 48.83 ± 7.79 mL/min to 60.48 ± 14.32 mL/min (P <0.0001). Two donors had hypertension postdonation while 23 did not. No donor developed postdonation proteinuria. A significant increase in the kidney size and GFR was evident in remnant native kidney in all. No mortality was observed.

摘要

评估了活体肾捐赠对捐赠者健康的影响,重点关注捐赠后血压(BP)、蛋白尿、肾脏大小和肾小球滤过率(GFR)。本研究纳入了25名捐赠后至少6个月的捐赠者。记录了肾切除时的捐赠者年龄、肾切除术后时长、捐赠前后的收缩压和舒张压测量值、捐赠后血尿素氮、血清肌酐和24小时蛋白尿、血糖、二维超声心动图。记录了捐赠前后的肾脏大小。通过慢性肾脏病流行病学合作组公式和肾病饮食改良公式计算GFR,并在所有捐赠者捐赠前后通过二乙三胺五乙酸肾图进行测量。21名(84%)为女性,4名(16%)为男性。捐赠时的平均年龄为46.24±9.62(28 - 65)岁。肾切除术后的中位时长为26(最短7个月,最长228个月)个月。收缩压平均升高6.24 mmHg,舒张压平均升高4.20 mmHg(P = 0.001)。残余肾脏大小从35.12±6.80平方厘米增加到42.32±8.59平方厘米(P <0.0001)。肾切除术后捐赠后GFR从94.50±18.12 mL/分钟降至60.48±14.32 mL/分钟(P <0.0001)。残余肾脏GFR从48.83±7.79 mL/分钟显著增加到60.48±14.32 mL/分钟(P <0.0001)。两名捐赠者捐赠后出现高血压,而23名未出现。没有捐赠者出现捐赠后蛋白尿。所有残余的天然肾脏均明显出现肾脏大小和GFR显著增加。未观察到死亡情况。

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