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分析活体肾供体的身体组成:对移植后肾功能的影响。

Analyzing body composition in living kidney donors: impact on post-transplant kidney function.

作者信息

Quint Evelien E, Westenberg Lisa B, Nieuwenhuijs-Moeke Gertrude J, van den Broek Eva A N, Zorgdrager Marcel, Viddeleer Alain R, Bakker Stephan J L, Nolte Ija M, van Londen Marco, Pol Robert A

机构信息

Department of Surgery, Division of Transplantation Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

Department of Anesthesiology, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands.

出版信息

Front Nephrol. 2024 Nov 25;4:1467669. doi: 10.3389/fneph.2024.1467669. eCollection 2024.

Abstract

Living donor kidney transplantation boasts superior patient and graft survival rates compared to deceased donor kidney transplantation. However, the impact of living donor body composition (BC) on post-transplant kidney function remains uncertain. In a cohort of 293 living kidney donor-recipients pairs, we utilized linear mixed model analyses, adjusted for time and including a multiplicative interaction term of time with the donor body composition measure, and found no significant associations between any donor BC measure and the annual change in recipient post-transplantation estimated glomerular filtration rate (eGFR) [donor body mass index (BMI): =-0.01, 95%CI -0.13; 0.11, =0.88; donor waist circumference: =0.02, 95%CI -0.02; 0.06, =0.38; donor skeletal muscle index: =-0.02, 95%CI -0.07; 0.04, =0.63; donor skeletal muscle radiation attenuation: =-0.002, 95%CI -0.06; 0.06, =0.96; donor visceral adipose tissue index: =-0.001, 95%CI -0.02; 0.02, =0.93; donor subcutaneous adipose tissue index: =-0.001, 95%CI -0.02; 0.02, =0.94; donor intramuscular adipose tissue index: =-0.12, 95%CI -0.29; 0.06, =0.19; donor total abdominal adipose tissue index: =-0.001, 95%CI -0.01; 0.01, =0.89]. Our study suggests that pre-donation BC does not affect post-transplantation recipient eGFR in donor populations with a BMI below 35 kg/m.

摘要

与 deceased donor kidney transplantation 相比,活体供肾移植的患者和移植物存活率更高。然而,活体供体身体组成(BC)对移植后肾功能的影响仍不确定。在一个由 293 对活体肾供体 - 受体组成的队列中,我们使用线性混合模型分析,对时间进行了调整,并纳入了时间与供体身体组成测量值的乘法交互项,结果发现任何供体 BC 测量值与受体移植后估计肾小球滤过率(eGFR)的年度变化之间均无显著关联[供体体重指数(BMI):=-0.01,95%CI -0.13;0.11,=0.88;供体腰围:=0.02,95%CI -0.02;0.06,=0.38;供体骨骼肌指数:=-0.02,95%CI -0.07;0.04,=0.63;供体骨骼肌辐射衰减:=-0.002,95%CI -0.06;0.06,=0.96;供体内脏脂肪组织指数:=-0.001,95%CI -0.02;0.02,=0.93;供体皮下脂肪组织指数:=-0.001,95%CI -0.02;0.02,=0.94;供体肌内脂肪组织指数:=-0.12,95%CI -0.29;0.06,=0.19;供体腹部总脂肪组织指数:=-0.001,95%CI -0.01;0.01,=0.89]。我们的研究表明,在 BMI 低于 35 kg/m 的供体人群中,捐赠前的 BC 不会影响移植后受体的 eGFR。 (注:deceased donor kidney transplantation 直译为“已故供体肾移植”,在医学领域可能有更专业的表述,这里保留英文是因为不确定其最合适的中文专业术语。)

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