小儿肾移植中不依从性与短暂性高尿酸血症之间的关联
Association Between Nonadherence and Transient Hyperuricemia in Pediatric Kidney Transplantation.
作者信息
Morizawa Y, Satoh H, Arai M, Iwasa S, Sato A, Fujimoto K
机构信息
Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Department of Urology, Nara Medical University, Kashihara, Nara, Japan.
Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
出版信息
Transplant Proc. 2023 Jan-Feb;55(1):129-133. doi: 10.1016/j.transproceed.2022.09.033. Epub 2022 Dec 28.
BACKGROUND
Nonadherence among pediatric transplant recipients is a significant problem that reduces graft survival and leads to poor kidney graft outcomes. It is, however, extremely difficult to detect during a regular follow-up. This study, therefore, aimed to investigate the risk factors involved in nonadherence, focusing on unexplained transient hyperuricemia in pediatric kidney transplant (KTx) recipients at a single pediatric center.
METHODS
This retrospective study included 167 patients who underwent KTx at our pediatric center. A Cox proportional hazards analysis was performed to evaluate the risk of nonadherence using the following factors: age, sex, body mass index SD score, transient hyperuricemia, hypertension, and follow-up period.
RESULTS
Nonadherence was identified in 19 patients (11%), with the average (SD) age and post-KTx duration at diagnosis being 17.21 (4.73) years and 79.21 (38.77) months, respectively. Thirty-four patients (20%) were diagnosed with transient hyperuricemia at a median of 14 months after KTx. On multivariate Cox regression analysis, transient hyperuricemia was the only independent risk factor for nonadherence after KTx.
CONCLUSIONS
Transient hyperuricemia was identified as one of the risk factors for nonadherence after KTx; therefore, careful monitoring for transient hyperuricemia may allow early detection of nonadherence.
背景
儿科移植受者的不依从是一个严重问题，会降低移植物存活率并导致肾移植预后不良。然而，在常规随访期间极难检测到。因此，本研究旨在调查不依从的相关危险因素，重点关注单一儿科中心儿科肾移植（KTx）受者中无法解释的短暂性高尿酸血症。
方法
这项回顾性研究纳入了在我们儿科中心接受KTx的167例患者。使用以下因素进行Cox比例风险分析以评估不依从的风险：年龄、性别、体重指数标准差评分、短暂性高尿酸血症、高血压和随访期。
结果
19例患者（11%）被确定为不依从，诊断时的平均（标准差）年龄和KTx后病程分别为17.21（4.73）岁和79.21（38.77）个月。34例患者（20%）在KTx后中位14个月时被诊断为短暂性高尿酸血症。多变量Cox回归分析显示，短暂性高尿酸血症是KTx后不依从的唯一独立危险因素。
结论
短暂性高尿酸血症被确定为KTx后不依从的危险因素之一；因此，仔细监测短暂性高尿酸血症可能有助于早期发现不依从情况。
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