Birmingham Cardio-Renal Group, Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Department of Nephrology, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom.
Clin J Am Soc Nephrol. 2020 Sep 7;15(9):1330-1339. doi: 10.2215/CJN.15651219. Epub 2020 Aug 25.
The Effect of a Reduction in GFR after Nephrectomy on Arterial Stiffness and Central Hemodynamics (EARNEST) study was a multicenter, prospective, controlled study designed to investigate the associations of an isolated reduction in kidney function on BP and arterial hemodynamics.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Prospective living kidney donors and healthy controls who fulfilled criteria for donation were recruited from centers with expertise in vascular research. Participants underwent office and ambulatory BP measurement, assessment of arterial stiffness, and biochemical tests at baseline and 12 months.
A total of 469 participants were recruited, and 306 (168 donors and 138 controls) were followed up at 12 months. In the donor group, mean eGFR was 27 ml/min per 1.73 m lower than baseline at 12 months. Compared with baseline, at 12 months the mean within-group difference in ambulatory day systolic BP in donors was 0.1 mm Hg (95% confidence interval, -1.7 to 1.9) and 0.6 mm Hg (95% confidence interval, -0.7 to 2.0) in controls. The between-group difference was -0.5 mm Hg (95% confidence interval, -2.8 to 1.7; =0.62). The mean within-group difference in pulse wave velocity in donors was 0.3 m/s (95% confidence interval, 0.1 to 0.4) and 0.2 m/s (95% confidence interval, -0.0 to 0.4) in controls. The between-group difference was 0.1 m/s (95% confidence interval, -0.2 to 0.3; =0.49).
Changes in ambulatory peripheral BP and pulse wave velocity in kidney donors at 12 months after nephrectomy were small and not different from controls.
NCT01769924 (https://clinicaltrials.gov/ct2/show/NCT01769924).
肾切除术后肾小球滤过率降低对动脉僵硬度和中心血液动力学的影响（EARNEST）研究是一项多中心、前瞻性、对照研究，旨在探讨孤立性肾功能降低与血压和动脉血液动力学的相关性。
设计、地点、参与者和测量方法：前瞻性招募符合捐献标准的活体供肾者和健康对照者，这些参与者来自血管研究专业中心。参与者在基线和 12 个月时接受诊室和动态血压测量、动脉僵硬度评估和生化检查。
共招募了 469 名参与者，其中 306 名（168 名供者和 138 名对照者）在 12 个月时进行了随访。在供者组中，平均 eGFR 在 12 个月时比基线下降了 27ml/min/1.73m。与基线相比，供者组的日间动态收缩压组内差异在 12 个月时为 0.1mmHg（95%置信区间，-1.7 至 1.9），对照组为 0.6mmHg（95%置信区间，-0.7 至 2.0）。组间差异为-0.5mmHg（95%置信区间，-2.8 至 1.7；=0.62）。供者组脉搏波速度的组内差异为 0.3m/s（95%置信区间，0.1 至 0.4），对照组为 0.2m/s（95%置信区间，-0.0 至 0.4）。组间差异为 0.1m/s（95%置信区间，-0.2 至 0.3；=0.49）。
肾切除术后 12 个月，供者的动态外周血压和脉搏波速度变化较小，与对照组无差异。
NCT01769924（https://clinicaltrials.gov/ct2/show/NCT01769924）。
