Explorations Fonctionnelles Physiologiques, Hôpital Rangueil, CHU de Toulouse, Toulouse, France.
Laboratoire de Physiologie, Facultés de médecine, Université Paul Sabatier, Toulouse, France.
J Nephrol. 2021 Oct;34(5):1651-1657. doi: 10.1007/s40620-021-01067-1. Epub 2021 Jun 1.
Although living kidney donation is not a high-risk surgery, there is still a need to identify situations at risk of kidney disease after uninephrectomy. Estrogens exhibit a protective role against various nephropathies. The aim of this study was to assess renal adaptation following nephrectomy according to menopausal status in women.
A prospective bicentric study including living women donors measured glomerular filtration rate (GFR) (inulin or Cr-EDTA clearances) and kidney volume (using CT-scan and 3-dimensional reconstruction), before and after 1-year post-uninephrectomy. Renal adaptation was compared according to menopausal status.
Sixteen non-menopausal women and 18 menopausal women were included. One year following uninephrectomy, the mean decrease in GFR (global population) was - 32 ± 12 ml/min/1.73 m, and the mean increase in remnant kidney volume was + 32 ± 13 cm/1.73 m. No significant difference was observed between the two groups for both the decrease in GFR (-32.9 ± 13.3 in non-menopausal vs - 31.5 ± 9.9 in menopausal, ml/min/1.73 m, p = 0.84), and the increase in kidney volume (+ 36.1 ± 13.4 in non-menopausal vs + 28.1 ± 12.5 in menopausal, cm/1.73 m, p = 0.09).
Menopausal status did not influence kidney adaptation following uninephrectomy, and in this respect is not a potential limiting factor for living kidney donation.
尽管活体肾脏捐献不是一项高风险的手术,但仍需要确定单侧肾脏切除术后发生肾脏疾病的风险情况。雌激素对各种肾脏疾病表现出保护作用。本研究旨在根据女性绝经状态评估单侧肾脏切除术后的肾脏适应情况。
一项前瞻性的中心研究纳入了 16 名非绝经女性和 18 名绝经女性的活体供者,在单侧肾脏切除术前和术后 1 年分别使用菊粉或 Cr-EDTA 清除率测量肾小球滤过率(GFR),并通过 CT 扫描和三维重建测量肾脏体积。根据绝经状态比较肾脏的适应情况。
16 名非绝经女性和 18 名绝经女性被纳入研究。单侧肾脏切除术后 1 年,GFR(总体人群)的平均下降值为-32±12ml/min/1.73m,残余肾脏体积的平均增加值为+32±13cm/1.73m。两组间 GFR 的下降值(非绝经组为-32.9±13.3ml/min/1.73m,绝经组为-31.5±9.9ml/min/1.73m,p=0.84)和肾脏体积的增加值(非绝经组为+36.1±13.4cm/1.73m,绝经组为+28.1±12.5cm/1.73m,p=0.09)均无显著差异。
绝经状态并未影响单侧肾脏切除术后的肾脏适应情况,因此绝经并不是活体肾脏捐献的潜在限制因素。