Department of Urology, Soonchunhyang University Seoul Hospital, 59 Daesagwan-Ro, Yongsan-Gu, Seoul, 04401, Korea.
BMC Nephrol. 2023 May 30;24(1):152. doi: 10.1186/s12882-023-03208-z.
Recent studies have shown that donor nephrectomy can induce renal function impairment. However, few meta-analysis studies about this have proceeded. Therefore, the objective of this systematic review and meta-analysis including all data of recent research studies was to determine whether living donor nephrectomy (LDN) could induce renal function impairment.
By November 2020, comprehensive literature searches were performed on PubMed, Embase, and Cochrane databases. Inclusion criteria were: (1) observational studies with data about overall end-stage renal disease (ESRD) or chronic kidney disease (CKD) of living kidney donors, (2) control group consisted of people without donor nephrectomy, and (3) outcomes of studies included long-term end-stage renal disease risks after living kidney donation. Risk of Bias in Non-randomized Studies of interventions (ROBINS-I) assessment tool was used to evaluate our methodological quality.
The qualitative review included 11 studies and the meta-analysis included 5 studies. In the meta-analysis, the integrated overall ESRD risk was 5.57 (95% CI: 2.03-15.30). Regarding the overall risk of bias using ROBINS-I assessment tool, 0 studies was rated as "Low", 7 studies were rated as "moderate", 2 studies were rated as "Serious", and two studies were rated as "Critical".
Our study showed that LDN increased ESRD risk in LDN patients. However, in our meta-analysis, variables in included studies were not uniform and the number of included studies was small. To have a definite conclusion, meta-analyses of well-planned and detailed studies need to be conducted in the future.
最近的研究表明，供体肾切除术可能会导致肾功能损害。然而，很少有关于这方面的荟萃分析研究。因此，本系统评价和荟萃分析包括了所有最近研究数据的目的是确定活体供肾切除术（LDN）是否会导致肾功能损害。
截至 2020 年 11 月，在 PubMed、Embase 和 Cochrane 数据库中进行了全面的文献检索。纳入标准为：（1）关于活体供肾者整体终末期肾病（ESRD）或慢性肾脏病（CKD）数据的观察性研究，（2）对照组由未行供肾切除术的人组成，（3）研究结果包括活体供肾后长期 ESRD 风险。使用非随机干预研究的偏倚风险（ROBINS-I）评估工具来评估我们的方法学质量。
定性综述包括 11 项研究，荟萃分析包括 5 项研究。在荟萃分析中，综合整体 ESRD 风险为 5.57（95%CI：2.03-15.30）。使用 ROBINS-I 评估工具对整体风险偏倚进行评估，0 项研究被评为“低”，7 项研究被评为“中度”，2 项研究被评为“严重”，2 项研究被评为“危急”。
我们的研究表明，LDN 增加了 LDN 患者的 ESRD 风险。然而，在我们的荟萃分析中，纳入研究的变量不一致，纳入的研究数量较少。为了得出明确的结论，未来需要进行精心设计和详细研究的荟萃分析。
