Hashimoto Junya, Hamasaki Yuko, Aoki Yujiro, Kubota Mai, Muramatsu Masaki, Kawamura Takeshi, Shishido Seiichiro, Sakai Ken
Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan.
Department of Pediatric Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan.
Pediatr Nephrol. 2023 Jan;38(1):291-297. doi: 10.1007/s00467-022-05540-2. Epub 2022 Apr 28.
This study aimed to evaluate the change in graft function in two groups stratified by the estimated glomerular filtration rate (eGFR) at 1 month after transplantation (eGFR-1 M) in pediatric living donor kidney transplant recipients.
Forty-three pediatric recipients were classified as those with an eGFR-1 M ≥ 90 mL/min/1.73 m (n = 19; high eGFR group) or those with an eGFR-1 M of 60-89 mL/min/1.73 m (n = 24; middle eGFR group). In the two groups, changes in the eGFR were retrospectively evaluated for 5 years after kidney transplantation.
The mean recipient age at transplantation in the high/middle eGFR group was 6.1 ± 3.4/7.8 ± 4.0 years (P = 0.14). The mean eGFR-1, -12, and -60 M (mL/min/1.73 m) in the high/middle eGFR group were 106.8 ± 2.99/78.5 ± 1.52 (P < 0.001), 79.3 ± 3.22/62.7 ± 2.38 (P < 0.001), and 73.1 ± 4.16/59.2 ± 2.79 (P = 0.006), respectively. The change in the mean eGFR remained mostly parallel in the two groups. In both groups, the eGFR significantly decreased only between 1 and 12 months after transplantation (P < 0.0001). Approximately 70% of the patients had an eGFR-60 M ≥ 60 mL/min/1.73 m.
The high and middle eGFR groups showed a rapid decline in the eGFR by 1 year after transplantation, but the change thereafter was gradual. In pediatric living donor kidney transplant recipients, the eGFR was relatively well maintained up to 5 years after transplantation. A higher resolution version of the Graphical abstract is available as Supplementary information.
本研究旨在评估小儿活体供肾移植受者中，根据移植后1个月估算肾小球滤过率（eGFR-1M）分层的两组受者移植肾功能的变化。
43例小儿受者被分为eGFR-1M≥90 mL/min/1.73m²的受者（n = 19；高eGFR组）和eGFR-1M为60-89 mL/min/1.73m²的受者（n = 24；中eGFR组）。对两组受者肾移植后5年的eGFR变化进行回顾性评估。
高/中eGFR组受者移植时的平均年龄分别为6.1±3.4/7.8±4.0岁（P = 0.14）。高/中eGFR组受者的平均eGFR-1M、-12M和-60M（mL/min/1.73m²）分别为106.8±2.99/78.5±1.52（P < 0.001）、79.3±3.22/62.7±2.38（P < 0.001）和73.1±4.16/59.2±2.79（P = 0.006）。两组受者平均eGFR的变化大多保持平行。两组受者的eGFR均仅在移植后1至12个月之间显著下降（P < 0.0001）。约70%的患者eGFR-60M≥60 mL/min/1.73m²。
高和中eGFR组受者在移植后1年内eGFR迅速下降，但此后变化较为缓慢。在小儿活体供肾移植受者中，移植后5年内eGFR相对维持良好。可获取更高分辨率的图形摘要作为补充信息。
