Lin Shih-Yi, Lin Cheng-Li, Sung Fung-Chang, Chang Chao-Hsiang, Wu His-Chin, Chen Wen-Chi, Wang I-Kuan, Chen Chao-Jung, Chou An-Kuo, Kao Chia-Hung
Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University.
Department of Internal Medicine.
Medicine (Baltimore). 2019 Feb;98(7):e14494. doi: 10.1097/MD.0000000000014494.
Few studies have investigated the risk of physiological sequelae in living kidney donors (KDs). We conducted a population-based cohort study using the National Health Insurance Research Database of Taiwan, which covers more than 99% of citizens.We comprehensively investigated the risk of medical disorders after kidney donation in living KDs using a maximum follow-up of 13 years. From January 1997 to December 2010, 1081 living KDs and 1082 age- and sex-matched non-KDs were eligible. Primary outcomes comprised end-stage renal disease, chronic kidney disease, stroke, cancer, acute myocardial infarction, acute renal failure (ARF), and diabetes.The adjusted hazard ratios (HRs) for developing ARF, diabetes, hyperlipidemia, hypertension, cancer, end-stage renal disease, acute myocardial infarction, and stroke were similar between the KD and non-KD cohorts (P > .05). Although differences in the adjusted HRs of ARF were nonsignificant, the cumulative incidence rate of ARF 13 years after donation was 7.48 per 1000 person-years in the KD cohort compared with 3.46 in the matched non-KD cohort. The incidence rate ratio for ARF between donors and nondonors significantly increased to 2.16 (95% confidence interval, 1.61-2.71).Living KDs experienced no significant health disorders following kidney donation but should be alert to the higher incidence rate of ARF.
很少有研究调查活体肾供者（KDs）出现生理后遗症的风险。我们利用覆盖超过99%台湾民众的全民健康保险研究数据库进行了一项基于人群的队列研究。我们对活体肾供者肾移植后的疾病风险进行了全面调查，最长随访时间为13年。1997年1月至2010年12月期间，1081名活体肾供者和1082名年龄及性别匹配的非肾供者符合条件。主要结局包括终末期肾病、慢性肾病、中风、癌症、急性心肌梗死、急性肾衰竭（ARF）和糖尿病。KD队列和非KD队列中发生ARF、糖尿病、高脂血症、高血压、癌症、终末期肾病、急性心肌梗死和中风的调整后风险比（HRs）相似（P>0.05）。尽管ARF调整后HRs的差异无统计学意义，但KD队列中肾移植后13年ARF的累积发病率为每1000人年7.48例，而匹配的非KD队列中为3.46例。供者与非供者之间ARF的发病率比显著增至2.16（95%置信区间，1.61 - 2.71）。活体肾供者在肾移植后未出现明显的健康问题，但应警惕ARF的较高发病率。
