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中国队列中原发性肝癌肝移植术后慢性肾脏病的发生率。

Incidence of chronic kidney disease after orthotopic liver transplantation in a Chinese cohort.

机构信息

Department of Critical Care, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.

出版信息

Clin Exp Nephrol. 2020 Sep;24(9):806-812. doi: 10.1007/s10157-020-01910-y. Epub 2020 Jun 5.

Abstract

BACKGROUND

Kidney dysfunction frequently occurred after orthotopic liver transplantation (OLT). Chronic renal disease (CKD) is a complicated problem and is associated with increased mortality. The aim of this study is to find the risk factors for the incidence of CKD at 1 year after OLT in China.

METHODS

From January 2017 to December 2017, we retrospectively assessed 280 recipients in our single center. Chronic renal failure was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m for 3 months, regardless of the presence or absence of structural kidney damage. Cox proportional hazard model was used to identify the factors to the incidence of CKD after liver transplantations. Kaplan-Meier plots with log-rank test were presented to evaluate patient survival time in those with and without CKD.

RESULTS

With a median follow-up of 17.4 months, 48 patients developed CKD after liver transplantations, representing 17.1% of the cohort. The cox-regression model showed that recipients age (HR = 1.097, P < 0.01), AKI (HR = 1.542, P < 0.01) and MELD score (HR = 1.077, P < 0.01) were significantly associated with the development of post-transplant CKD at 1 year. Recipient survival at 1 year was significantly worse in recipients with CKD compared to those without CKD (P < 0.01) after adjustment by age and gender.

CONCLUSION

Our findings suggested that age, AKI and MELD score were associated with the incidence of CKD 1 year after OLT in a Chinese cohort. Recipients with CKD were associated with worse survival.

摘要

背景

肝移植(OLT)后常发生肾功能障碍。慢性肾脏病(CKD)是一个复杂的问题,与死亡率增加有关。本研究旨在寻找中国 OLT 后 1 年内发生 CKD 的危险因素。

方法

本研究回顾性评估了 2017 年 1 月至 2017 年 12 月在我们单一中心的 280 名受者。慢性肾衰竭定义为肾小球滤过率估计值(eGFR)<60 ml/min/1.73 m2 持续 3 个月,无论是否存在结构性肾脏损伤。Cox 比例风险模型用于识别肝移植后 CKD 发生的因素。Kaplan-Meier 图和对数秩检验用于评估有和无 CKD 的患者的生存时间。

结果

中位随访 17.4 个月后,48 例患者发生肝移植后 CKD,占队列的 17.1%。Cox 回归模型显示,受者年龄(HR=1.097,P<0.01)、急性肾损伤(HR=1.542,P<0.01)和 MELD 评分(HR=1.077,P<0.01)与 1 年后移植后 CKD 的发生显著相关。在调整年龄和性别后,CKD 患者的 1 年生存率明显低于无 CKD 患者(P<0.01)。

结论

我们的研究结果表明,年龄、AKI 和 MELD 评分与中国队列 OLT 后 1 年内 CKD 的发生率相关。CKD 患者的生存率较差。

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