Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Am J Transplant. 2021 May;21(5):1857-1865. doi: 10.1111/ajt.16384. Epub 2020 Nov 22.
Reduced renal function is associated with cardiovascular disease (CVD); however, how living donor nephrectomy affects the risk of CVD remains controversial. We conducted a nationwide cohort study including living kidney donors in Denmark from 1996 to 2018 to assess the risk of hypertension, atrial fibrillation/flutter (AF), major adverse cardiovascular events (MACE; composite of myocardial infarction, ischemic stroke, and death) and death after living kidney donation. As comparisons we identified: a cohort of healthy individuals from the general population and an external blood donor cohort. We followed kidney donors (1,103 when compared with the general population cohort; 1,007 when compared with blood donors) for a median of 8 years. Kidney donors had an increased risk of initiating treatment for hypertension when compared with blood donors (standardized incidence ratio [SIR], 1.40; 95% confidence interval [CI], 1.17-1.66) but they did not have increased risk of MACE neither when compared with the general population cohort (hazard ratio, 0.68; 95% CI, 0.52-0.89) nor with blood donors (SIR, 1.17; 95% CI, 0.88-1.55). Neither did they have increased risks of AF and death. Thus, living kidney donation may be associated with increased risk of hypertension; however, we did not identify increased risks of CVD or death.
肾功能降低与心血管疾病（CVD）有关；然而，活体供肾切除术如何影响 CVD 的风险仍存在争议。我们进行了一项全国性队列研究，纳入了 1996 年至 2018 年期间丹麦的活体肾供者，以评估活体肾捐献后高血压、心房颤动/扑动（AF）、主要不良心血管事件（MACE；心肌梗死、缺血性卒中和死亡的综合）和死亡的风险。作为对照，我们确定了：一般人群中的健康个体队列和外部献血者队列。我们对肾供者（与一般人群队列相比为 1103 人；与献血者相比为 1007 人）进行了中位数为 8 年的随访。与献血者相比，肾供者开始治疗高血压的风险增加（标准化发病比 [SIR]，1.40；95%置信区间 [CI]，1.17-1.66），但与一般人群队列（风险比，0.68；95%CI，0.52-0.89）或与献血者（SIR，1.17；95%CI，0.88-1.55）相比，MACE 风险并未增加。他们也没有增加 AF 和死亡的风险。因此，活体肾捐献可能与高血压风险增加有关；然而，我们没有发现 CVD 或死亡风险增加。
