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中国西南地区肾移植受者肾功能影响因素分析:一项回顾性研究

Analysis of Factors Influencing Kidney Function of Recipients After Renal Transplantation in Southwestern China: A Retrospective Study.

作者信息

Xin Zhaodan, Wu Lijuan, Zhou Juan, Zhuang Jie, Peng Wu, Song Turun, Lin Tao, Lu Xiaojun, Ying Binwu

机构信息

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.

West China School of Medicine, Sichuan University, Chengdu, China.

出版信息

Front Med (Lausanne). 2020 Nov 12;7:519582. doi: 10.3389/fmed.2020.519582. eCollection 2020.

Abstract

Factors influencing the kidney function of patients after renal transplantation include both recipient-related factors and donor-related factors. To gain a better understanding of these factors and to improve clinical decision-making, we performed a retrospective study of southwestern Chinese people receiving kidney transplantation. In this retrospective analysis, a total of 2,462 recipients receiving allogeneic kidney transplantation in West China Hospital of Sichuan University from December 13, 2008 to January 10, 2018 were included. Data on recipient and donor characteristics were extracted from the Transplant Center Database and stratified by discrete time points after kidney transplantation. Univariate and multivariate logistic regression analyses were carried out on the study variables, and kidney function of postoperative patients was monitored using cystatin C (CysC) as the outcome indicator. From the univariate analysis, several factors showed statistically significant short-term impact on kidney function based on CysC after kidney transplantation, including age, ethnicity, body mass index (BMI), and HLA A-B-DR-DQ loci mismatch. Gender of recipients and gender-consistency between donors and recipients revealed both short-term and long-term influence. Younger donors had significantly better medium-and-long-term influence on kidney function. From the multivariate logistic regression analysis, recipient gender, ethnicity, BMI, and donor age were independent factors affecting postoperative CysC recovery at discrete time points. Several factors of recipients related to renal function after kidney transplantation, such as gender, ethnicity, BMI and donor's age should be paid more attention to. Moreover, female and non-Han recipients decreased the risk of poor outcome during postoperative kidney function recovery while large BMI of recipients and higher donor age increased the risk. It is useful to predict the postoperative renal function earlier according to corresponding factors, and improve the patient's quality of life.

摘要

影响肾移植患者肾功能的因素包括受者相关因素和供者相关因素。为了更好地了解这些因素并改善临床决策,我们对接受肾移植的中国西南地区人群进行了一项回顾性研究。在这项回顾性分析中,纳入了2008年12月13日至2018年1月10日在四川大学华西医院接受同种异体肾移植的2462例受者。从移植中心数据库中提取受者和供者特征的数据,并按肾移植后的离散时间点进行分层。对研究变量进行单因素和多因素逻辑回归分析,并以胱抑素C(CysC)作为结局指标监测术后患者的肾功能。单因素分析显示,基于肾移植后CysC,有几个因素对肾功能有统计学意义的短期影响,包括年龄、种族、体重指数(BMI)和HLA A-B-DR-DQ位点错配。受者性别以及供者与受者之间的性别一致性显示出短期和长期影响。年轻供者对肾功能的中长期影响明显更好。多因素逻辑回归分析显示,受者性别、种族、BMI和供者年龄是影响离散时间点术后CysC恢复的独立因素。肾移植后与肾功能相关的受者的几个因素,如性别、种族、BMI和供者年龄应得到更多关注。此外,女性和非汉族受者在术后肾功能恢复期间不良结局风险降低,而受者BMI大以及供者年龄高则增加风险。根据相应因素早期预测术后肾功能,并改善患者生活质量是有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6315/7689199/d53e7bd55cc0/fmed-07-519582-g0001.jpg

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