Abdellaoui Imen, Sahtout Wissal, Awatef Azzabi, Zallama Dorsaf, Achour Abdellatif
Department of Nephrology, Dialysis and Transplantation, Sahloul Hospital, University of Medicine, Sousse, Tunisia.
Saudi J Kidney Dis Transpl. 2019 Jul-Aug;30(4):873-882. doi: 10.4103/1319-2442.265463.
Living donor kidney transplantation is the treatment of choice for the patients with end-stage renal disease, especially where deceased donor programs are limited. There are limited data on the outcomes of living kidney donors (LKD) from developing countries, especially from North Africa. The aim of this study is to evaluate the prevalence of hypertension (HTN) in LKD and to analyze its risk factors. This is a longitudinal monocentric study, and the donors who underwent nephrectomy for donation between 2006 and 2015 were included. Ninety-two donors were assessed. The mean age at the time of nephrectomy was 42.8 ± 10 years (21-68 years). The sex ratio was 0.6. At the time of donation, the median systolic blood pressure was 120 mm Hg and the median diastolic blood pressure was 70 mm Hg. HTN was noted in 4% of donors. The median follow-up duration was 26 months. Two years after donation, the prevalence of HTN was 28% in the study group (8% male and 20% female). The mean time to development of HTN was 16 months. Associations between HTN after donation and the cardiovascular family history, age >40 years, HTN, obesity, android obesity, glomerular filtration rate GFR <90 mL/min/1.73 m, perioperative HTN, and dyslipidemia were noted. The multivariate analysis showed that obesity at the time of donation was a risk factor for HTN (odds ratio = 4.8; P = 0.04). Obese donor [body mass index (BMI) ≥30)] has higher risk of HTN after nephrectomy than nonobese donor.
活体供肾移植是终末期肾病患者的首选治疗方法，尤其是在 deceased donor 项目有限的情况下。关于来自发展中国家，特别是来自北非的活体肾供者（LKD）结局的数据有限。本研究的目的是评估 LKD 中高血压（HTN）的患病率并分析其危险因素。这是一项纵向单中心研究，纳入了 2006 年至 2015 年间因捐赠而接受肾切除术的供者。对 92 名供者进行了评估。肾切除术时的平均年龄为 42.8±10 岁（21 - 68 岁）。性别比为 0.6。捐赠时，收缩压中位数为 120 mmHg，舒张压中位数为 70 mmHg。4%的供者被发现患有 HTN。中位随访时间为 26 个月。捐赠后两年，研究组中 HTN 的患病率为 28%（男性 8%，女性 20%）。HTN 发生的平均时间为 16 个月。观察到捐赠后 HTN 与心血管家族史、年龄>40 岁、HTN、肥胖、腹型肥胖、肾小球滤过率 GFR<90 mL/min/1.73 m²、围手术期 HTN 和血脂异常之间的关联。多变量分析显示，捐赠时肥胖是 HTN 的一个危险因素（比值比 = 4.8；P = 0.04）。肥胖供者[体重指数（BMI）≥30]肾切除术后发生 HTN 的风险高于非肥胖供者。
