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肾移植受者移植后贫血模式的变化:受者的性别作用及供体类型

Change in the Pattern of Posttransplantation Anemia in Kidney Receptors: Sex Role in Recipients and Type of Donor.

作者信息

Cruz-Santiago José, Velázquez-Zambrano Carmen, Escamilla-Galindo Pedro Aarón, Díaz-Rosas Gabriela, Rojas-Rodríguez Felipe Octavio, Venegas-Vera Ángel Verner, López-López Bibiana, Bernáldez-Gómez German, Colbert Gates B, Mejía Velázquez Jorge Luís, Aguilera-Vallejo Jesús Eduardo, Hernández-Rivera Juan Carlos H, Paniagua-Sierra Ramón

机构信息

Renal Transplant Unit, La Raza National Health Care Medical Center, Mexican Social Security Institute, México City, México.

Texas A&M College of Medicine, Dallas, Texas.

出版信息

Transplant Proc. 2020 May;52(4):1163-1168. doi: 10.1016/j.transproceed.2019.12.050. Epub 2020 Mar 19.

Abstract

OBJECTIVE

Posttransplant anemia (PTA) in kidney recipients is a complication that has repercussions mainly of cardiovascular consequence. The objective of this study is to determine the prevalence of anemia, as well as the relationship between kidney recipient and donor sex, in the presence or absence of anemia at 12 months after kidney transplant (KT).

MATERIAL AND METHODS

Observational, longitudinal study of KTs made over a 5-year period, from 2013 to 2017, in a renal transplant unit from La Raza National Health Care Medical Center. Three hundred twenty-eight records were analyzed. Hemoglobin (Hb) and the presence or absence of anemia according to the definition by the World Health Organization were analyzed. The association between kidney recipient sex and donor type (living or deceased) was evaluated. Analysis of central tendency and dispersion were performed and the mean difference was established with χ test or Student t test. Significance level was set at P < .05.

RESULTS

The mean Hb (standard deviation) before KT was 10.38 (2.16) g/dL; Hb at 12 months was 14.47 (2.37) g/dL with an absolute increase of 4.09 g/dL. Before KT, male kidney recipients had a mean Hb of 10.54 (2.17) g/dL. At 12 months post-KT, mean Hb was 15.33 (2.25) with a change of 4.79 g/dL. Before KT, female kidney recipients had a mean Hb of 10.16 (2.13) g/dL. At 12 months post-KT, mean Hb was 13.31 (2.01) with a change of 3.15 g/dL. The difference between both sexes was 1.64 g/dL at the end of 12 months. Sixteen out of 152 (10.5%) patients had a serum creatinine (Cr) < 1.2 mg/dL and anemia; 36 out of 176 (20.5%) patients had a Cr ≥ 1.2 mg/dL and anemia (P = .014). In the bivariate logistic regression with an odds ratio of 2.047 (95% confidence interval, 1027-4078; P = .042) for higher Cr levels and the presence of persistent anemia.

CONCLUSIONS

There is a prevalence of anemia in female kidney recipients and recipients of kidneys from deceased donors. There is a higher risk of persistent anemia in the case of patients with some degree of graft failure at 12 months.

摘要

目的

肾移植受者的移植后贫血(PTA)是一种并发症,主要会产生心血管方面的影响。本研究的目的是确定贫血的患病率,以及肾移植受者与供者性别之间在肾移植(KT)后12个月有无贫血情况下的关系。

材料与方法

对2013年至2017年5年间在拉扎国家医疗中心肾脏移植科进行的肾移植进行观察性纵向研究。分析了328份记录。根据世界卫生组织的定义分析血红蛋白(Hb)及有无贫血情况。评估肾移植受者性别与供者类型(活体或 deceased)之间的关联。进行集中趋势和离散度分析,并通过χ检验或学生t检验确定均值差异。显著性水平设定为P <.05。

结果

肾移植前Hb(标准差)均值为10.38(2.16)g/dL;12个月时Hb为14.47(2.37)g/dL,绝对增加4.09 g/dL。肾移植前,男性肾移植受者Hb均值为10.54(2.17)g/dL。肾移植后12个月,Hb均值为15.33(2.25),变化4.79 g/dL。肾移植前,女性肾移植受者Hb均值为10.16(2.13)g/dL。肾移植后12个月,Hb均值为13.31(2.01),变化3.15 g/dL。12个月末,两性之间的差异为1.64 g/dL。152名患者中有16名(10.5%)血清肌酐(Cr)<1.2 mg/dL且有贫血;176名患者中有36名(20.5%)Cr≥1.2 mg/dL且有贫血(P =.014)。在二元逻辑回归中,较高的Cr水平与持续性贫血存在的比值比为2.047(95%置信区间,1027 - 4078;P =.042)。

结论

女性肾移植受者及 deceased 供肾受者中存在贫血现象。12个月时存在一定程度移植失败的患者持续性贫血风险更高。

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