Luo You, Zhang Yang, Tang Zuofu, Zhang Jinhua, Na Ning, Xiao Hengjun
Department of Kidney Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Ren Fail. 2024 Dec;46(2):2436629. doi: 10.1080/0886022X.2024.2436629. Epub 2024 Dec 3.
It is unknown when inosine was first employed as a renoprotective agent in the context of kidney transplantation procedures. However, there is no clinical evidence to support a protective role of inosine. The aim of this study was to investigate the effect of inosine on graft recovery.
Data related to donors and recipients were retrieved from relevant records between 2015 and 2023. A total of 1138 kidney transplant cases were identified, including 1005 recipients who received a bolus of 1000 mg inosine and 133 recipients who did not receive inosine during transplantation surgery. The endpoints of the analysis included recipient recovery after transplantation as assessed by delayed graft function (DGF), peak estimated glomerular filtration rate (eGFR) after transplantation, and unfavorable graft function recovery.
Given the high dimensionality of the donor and recipient variables, propensity score weighting analyses were conducted. No significant differences in the risk of DGF (OR = 0.80 [0.52, 1.22], = 0.301), unfavorable graft function recovery (OR = 0.95 [0.61, 1.51], = 0.842) or peak eGFR after transplantation (β = 1.61 [-4.33, 7.56], = 0.594) were observed between the inosine and no-inosine groups overlap weighting analysis.
Intraoperative infusion of 1000 mg of inosine has no effect on graft recovery after kidney transplantation. Therefore, the practice of using inosine during kidney transplantation surgery is not supported by evidence.
目前尚不清楚肌苷在肾移植手术中首次作为肾脏保护剂使用的时间。然而，尚无临床证据支持肌苷的保护作用。本研究的目的是调查肌苷对移植肾恢复的影响。
从2015年至2023年的相关记录中检索供体和受体的相关数据。共确定了1138例肾移植病例，其中1005例受体在移植手术期间接受了1000毫克肌苷的推注，133例受体未接受肌苷。分析的终点包括移植后受体恢复情况，通过移植肾功能延迟恢复（DGF）、移植后峰值估计肾小球滤过率（eGFR）以及移植肾功能不良恢复情况进行评估。
鉴于供体和受体变量的高维度性，进行了倾向评分加权分析。在肌苷组和非肌苷组之间，未观察到DGF风险（OR = 0.80 [0.52, 1.22]，P = 0.301）、移植肾功能不良恢复风险（OR = 0.95 [0.61, 1.51]，P = 0.842）或移植后峰值eGFR（β = 1.61 [-4.33, 7.56]，P = 0.594）的显著差异（重叠加权分析）。
术中输注1000毫克肌苷对肾移植后的移植肾恢复没有影响。因此，肾移植手术中使用肌苷的做法没有证据支持。
