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活体肾供者的长期肾脏和心血管结局:一项单中心回顾性观察研究。

Long-term renal and cardiovascular outcome of living kidney donors: A single-center retrospective observation study.

作者信息

Colucci Vincenza, Gallo Pasquale, Simone Simona, Morrone Luigi, Alfieri Carlo Maria, Gesualdo Loreto, Castellano Giuseppe

机构信息

Struttura Complessa di Nefrologia e Dialisi, P.O.C. "S.S. Annunziata", A.S.L. Taranto, Taranto, Italy.

Nephrology Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari "Aldo Moro," Bari, Italy.

出版信息

Front Med (Lausanne). 2022 Sep 14;9:966038. doi: 10.3389/fmed.2022.966038. eCollection 2022.

Abstract

BACKGROUND

The nephrectomy for donation reduces the renal parenchyma and glomerular filtration rate (GFR). It is important to understand the clinical consequences of kidney donation by a living donor.

METHODS

In this single-center, observational, retrospective study, we defined the renal and cardiovascular outcomes of living kidney donors. We analyzed data of 124 donors who donated at the Kidney Transplant Center (TC) of Bari between February 2002 and December 2018. Biometric data collected at visit 0, that is, at the time of the study of the donor candidate, and at visit 1, or rather at the last nephrological checkup (October-2018/August-2019) were compared.

RESULTS

An overall drop in GFR of 29 mL/min was observed over the analyzed period of 81+/-59 months. At visit 1, two donors developed chronic renal failure, including one in ESKD who underwent a kidney transplant. No relationship between age at donation and GFR drop was found. A trend toward an increase in obese people was reported; 28% of patients had compensated dyslipidemia and 35% were treated for hypertension. During the follow-up time, 3% had major cardiovascular events and 24% were lost to follow-up. One patient died.

CONCLUSION

The age of the donor does not represent a basic element for reducing GFR or for the occurrence of major cardiovascular events. Furthermore, older donor candidates, in optimal health, should not be excluded from the donation. It is important to promote careful and timely follow-up of the donor, preventing the most common clinical consequences of nephrectomy, in consideration of the poor compliance of a large part of donors over the long-term post-donation period.

摘要

背景

供体肾切除术会减少肾实质和肾小球滤过率(GFR)。了解活体供肾的临床后果很重要。

方法

在这项单中心、观察性、回顾性研究中,我们定义了活体肾供体的肾脏和心血管结局。我们分析了2002年2月至2018年12月期间在巴里肾脏移植中心(TC)进行捐献的124名供体的数据。比较了在访视0(即供体候选人研究时)和访视1(即最后一次肾脏检查时,2018年10月/2019年8月)收集的生物特征数据。

结果

在81±59个月的分析期内,观察到GFR总体下降了29 mL/分钟。在访视1时,两名供体出现慢性肾衰竭,其中一名终末期肾病患者接受了肾脏移植。未发现捐献时的年龄与GFR下降之间存在关联。报告显示肥胖人群有增加的趋势;28%的患者患有代偿性血脂异常,35%的患者接受高血压治疗。在随访期间,3%的患者发生了重大心血管事件,24%的患者失访。一名患者死亡。

结论

供体年龄不是降低GFR或发生重大心血管事件的基本因素。此外,健康状况良好的老年供体候选人不应被排除在捐献之外。考虑到很大一部分供体在捐献后的长期内依从性较差,促进对供体进行仔细和及时的随访,预防肾切除术后最常见的临床后果非常重要。

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