Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Kidney Dis. 2020 Sep;14(5):399-404.
Pulmonary hypertension (PHTN) is a common complication in patients with chronic kidney disease. Delayed Graft Function (DGF), on the other hand; is an essential complication after kidney transplantation. These two complications increase morbidity and mortality in patients. The effect of PHTN on cardiovascular and graft blood supply, as well as the same mechanisms underlying PTHN and DGF; led us to investigate the relationship between them.
In this retrospective cohort study, 306 patients aged 18 years or older who underwent kidney transplantation at our center over a 4-year were enrolled. PTHN was diagnosed by transthoracic echocardiography performed by a cardiologist. DGF refers to the cases where the patient needs dialysis in the first week after kidney transplantation or if serum creatinine is ≥ 3 mg/dL on the 5th day after surgery.
The prevalence of PHTN was 43 (14.1%), and the prevalence of DGF was 80 (26.1%). PHTN was not correlated with age, sex, duration of dialysis, type of dialysis, and cause of renal failure. But DGF was associated with the duration and type of dialysis. DGF was found to be higher in patients undergoing hemodialysis (P < .05), and patients with a higher mean duration of dialysis were also more likely to have DGF (P < .05). Also, we concluded that there was a significant relationship between PHTN and DGF (P < .05), meaning that patients with PTHN before transplantation were more likely to develop DFG.
This study found that pre-transplant PTHN is an independent predictor of DGF in renal transplant patients.
肺动脉高压（PHTN）是慢性肾脏病患者的常见并发症。另一方面，延迟肾功能恢复（DGF）是肾移植后的一个重要并发症。这两种并发症增加了患者的发病率和死亡率。PHTN 对心血管和移植物血液供应的影响，以及 PTHN 和 DGF 的相同机制，使我们研究了它们之间的关系。
在这项回顾性队列研究中，我们纳入了在中心接受肾移植的 306 名年龄在 18 岁及以上的患者。PTHN 通过心脏病专家进行的经胸超声心动图诊断。DGF 是指患者在肾移植后第一周需要透析，或术后第 5 天血清肌酐≥3mg/dL 的情况。
PHTN 的患病率为 43 例（14.1%），DGF 的患病率为 80 例（26.1%）。PHTN 与年龄、性别、透析时间、透析类型和肾衰竭原因无关。但 DGF 与透析时间和类型有关。血液透析患者的 DGF 发生率更高（P<0.05），透析时间较长的患者也更容易发生 DGF（P<0.05）。此外，我们得出结论，PHTN 和 DGF 之间存在显著关系（P<0.05），这意味着移植前患有 PTHN 的患者更有可能发生 DFG。
本研究发现，移植前的 PTHN 是肾移植患者 DGF 的独立预测因子。
