早期蛋白尿对活体供肾肾移植术后一年移植肾功能的影响。
Effect of earlier-proteinuria on graft functions after one-year living donor renal transplantation.
作者信息
Dai Zaiyou, Ye Luxi, Chen Dajin, Zhang Xing, Wang Meifang, Wang Rending, Wu Jianyong, Chen Jianghua
机构信息
Department of The Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China.
Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang, China.
出版信息
Oncotarget. 2017 Jul 15;8(35):59103-59112. doi: 10.18632/oncotarget.19260. eCollection 2017 Aug 29.
BACKGROUND
Proteinuria is an indicator of subsequent renal function decline in most nephropathies and early proteinuria has been assumed to be a risk factor of poor kidney transplant outcomes. However, there is no information about the effect of earlier-proteinuria at the first week on short-term graft function after living donor renal transplantation.
METHODS
Retrospective cohort study of 439 living donor kidney transplants to analyze the effect of early proteinuria at 7-day post-transplantation on short-term prognosis of living donor renal transplantation. Patients were stratified into 2 groups according to the definition of earlier-proteinuria: Group A as proteinuria < 0.4 g/24h and Group B as proteinuria ≥ 0.4 g/24h, and differences over the first year post-transplantation were analyzed.
RESULTS
Patients with earlier-proteinuria ≥ 0.4 g/24h had a significantly higher 1-year proteinuria and lower 1-year graft function post-transplantation. Discrepancies of weight ratio of donor-recipient and mean artery pressure difference of recipient to donor influenced the urine protein excretion at the 7-day post-transplantation.
CONCLUSIONS
Earlier-proteinuria at 7-day after living donor renal transplantation was associated with short-term graft function. To eliminate the functional discrepancies between living donors and recipients could be viewed as a solution of reducing earlier-proteinuria.
背景
蛋白尿是大多数肾病患者肾功能随后下降的一个指标，早期蛋白尿一直被认为是肾移植预后不良的一个危险因素。然而，关于活体供肾移植术后第一周早期蛋白尿对短期移植肾功能的影响尚无相关信息。
方法
对439例活体供肾移植进行回顾性队列研究，分析移植后7天早期蛋白尿对活体供肾移植短期预后的影响。根据早期蛋白尿的定义将患者分为两组：A组为蛋白尿<0.4g/24小时，B组为蛋白尿≥0.4g/24小时，并分析移植后第一年的差异。
结果
早期蛋白尿≥0.4g/24小时的患者移植后1年蛋白尿显著更高，移植肾功能更低。供受者体重比差异和受者与供者平均动脉压差异影响移植后7天的尿蛋白排泄。
结论
活体供肾移植术后7天的早期蛋白尿与短期移植肾功能相关。消除供受者之间的功能差异可被视为减少早期蛋白尿的一种解决办法。
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