Tatar Erhan, Karataş Murat, Kılıç Mustafa, Tercan Ismail Can, Okut Gokalp, Usoğlu Berkant, Aykas Ahmet, Uslu Adam
From the Department of Nephrology, University of Health Sciences, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey.
Exp Clin Transplant. 2019 Jan;17(Suppl 1):156-158. doi: 10.6002/ect.MESOT2018.P32.
The development of hypertension can negatively affect cardiovascular and renal outcomes in renal kidney donors. Here, we retrospectively investigated the frequency and risk factors of hypertension development in healthy renal donors at our center.
Living donors of kidney transplants performed between January 1998 and December 2016 were evaluated. Those > 18 years old, having glomerular filtration rate > 70 mL/min/1.72 m², body mass index ≤ 35 kg/m², and proteinuria < 300 mg/day were eligible. Those with a history of diabetes and hypertension and < 1 year of follow-up were excluded.
In the 190 included donors, mean follow-up was 56 ± 45 months, mean age was 47 ± 10 years, and 48% were women. Baseline systolic and diastolic blood pressures were 118 ± 13 and 76 ± 8.8 mm Hg. Follow-up showed that 19 donors (10%) developed hypertension. These donors were older and had higher baseline systolic blood pressure (126 ± 13 vs 117 ± 12 mm Hg; P = .003), proteinuria (162 ± 89 vs 117 ± 63 mg/day; P = .05), fasting blood glucose (99 ± 10 vs 94 ± 9.6 mg/dL; P = .03), and uric acid levels (5.4 ± 1.7 vs 4.5 ± 1.2 mg/dL; P = .04). Although these donors had baseline glomerular filtration rates (97 ± 22 vs 104 ± 22 mL/min/1.72 m²; P = .19) similar to other donors, levels were lower at last follow-up (62 ± 14 vs 71 ± 19 mL/min/1.72 m²; P= .03). In multiple regression analysis, preoperative fasting blood glucose, systolic blood pressure, and serum uric acid levels independently predicted hypertension development.
In healthy renal donors, preoperative detailed evaluations can provide important information foreseeing the development of hypertension after nephrectomy.
高血压的发生会对肾移植供体的心血管和肾脏预后产生负面影响。在此，我们回顾性调查了本中心健康肾移植供体中高血压发生的频率及危险因素。
对1998年1月至2016年12月期间进行肾移植的活体供体进行评估。入选标准为年龄>18岁，肾小球滤过率>70 mL/min/1.72 m²，体重指数≤35 kg/m²，蛋白尿<300 mg/天。排除有糖尿病和高血压病史以及随访时间<1年的供体。
在纳入研究的190例供体中，平均随访时间为56±45个月，平均年龄为47±10岁，48%为女性。基线收缩压和舒张压分别为118±13和76±8.8 mmHg。随访结果显示，19例（10%）供体发生高血压。这些供体年龄较大，基线收缩压较高（126±13 vs 117±12 mmHg；P = 0.003），蛋白尿水平较高（162±89 vs 117±63 mg/天；P = 0.05）,空腹血糖水平较高（99±10 vs 94±9.6 mg/dL；P = 0.03），尿酸水平较高（5.4±1.7 vs 4.5±1.2 mg/dL；P = 0.04）。尽管这些供体的基线肾小球滤过率与其他供体相似（97±22 vs 104±22 mL/min/1.72 m²；P = 0.19），但在末次随访时其水平较低（62±14 vs 71±19 mL/min/1.72 m²；P = 0.03）。在多因素回归分析中，术前空腹血糖、收缩压和血清尿酸水平可独立预测高血压的发生。
对于健康肾移植供体，术前详细评估可为预见肾切除术后高血压的发生提供重要信息。
