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血浆高致动脉粥样硬化指数与活体供肾移植受者移植肾功能延迟相关:越南单中心研究

High Atherogenic Index of Plasma Associated With Delayed Graft Function in Living Donor Renal Transplant Recipients: A Single-Center Study in Vietnam.

作者信息

Pham Thai Dung, Nguyen Thi Thu Ha, Nguyen Tri Tue, Tran Dac Tiep, Nguyen Trung Kien, Nguyen Huu Dung, Hoang Anh Trung, Tran Van Hinh, Le Viet Thang

机构信息

Military Hospital 103, Hanoi, Vietnam.

Vietnam Military Medical University, Hanoi, Vietnam.

出版信息

J Clin Lab Anal. 2025 Jan;39(2):e25142. doi: 10.1002/jcla.25142. Epub 2024 Dec 24.

Abstract

PURPOSE

To determine the predictive value of the atherogenic index of plasma before transplant for delayed graft function.

PATIENTS AND METHODS

A cross-sectional, longitudinal, non-interventional, non-controlled study of 167 patients undergoing kidney transplantation from living donors, with a mean age of 39.34 ± 11.86 years old, 53.3% male, and a pre-transplant hemodialysis time of 14 (7-36) months. Delayed graft function was defined as decreased blood creatinine < 25% within the first 24 h compared to pre-transplantation, and the patients needed hemodialysis in the first 7 days. The atherogenic index of plasma was calculated based on pre-transplant plasma triglycerides and high-density lipoprotein cholesterol concentrations.

RESULTS

The ratio of delayed graft function in renal transplant recipients from living donors was 13.8% (23/167 patients). Hemodialysis time, the ratio of hepatitis infection, overweight and obese, atherosclerosis, positive PRA, and acute rejection in the DGF (+) group were higher than those of the DGF (-) group, p < 0.05 and < 0.001. In particular, plasma CRP-hs level and AIP also were higher in DGF (+) patients compared to those of DGF (-) ones, p < 0.001. Long hemodialysis time, obesity, high plasma CRP-hs, and high AIP in pre-transplant patients were independent factors related to DGF and had predictive value for DGF after kidney transplantation, in which AIP had good predictive value: AUC = 0.859, p < 0.001.

CONCLUSION

Delayed graft function was relatively common in renal transplant recipients from living donors. AIP before kidney transplant was a good predictor for delayed graft function.

摘要

目的

确定移植前血浆致动脉粥样硬化指数对移植肾功能延迟的预测价值。

患者与方法

对167例接受活体供肾移植的患者进行了一项横断面、纵向、非干预性、非对照研究,患者平均年龄为39.34±11.86岁,男性占53.3%,移植前血液透析时间为14(7 - 36)个月。移植肾功能延迟定义为与移植前相比,术后24小时内血肌酐下降<25%,且患者在术后第1个7天内需进行血液透析。根据移植前血浆甘油三酯和高密度脂蛋白胆固醇浓度计算血浆致动脉粥样硬化指数。

结果

活体供肾移植受者中移植肾功能延迟的比例为13.8%(23/167例患者)。移植肾功能延迟(DGF)(+)组的血液透析时间、肝炎感染比例、超重和肥胖、动脉粥样硬化、群体反应性抗体(PRA)阳性以及急性排斥反应均高于DGF(-)组,p<0.05和<0.001。特别是,与DGF(-)组患者相比,DGF(+)组患者的血浆高敏C反应蛋白(CRP - hs)水平和致动脉粥样硬化指数(AIP)也更高,p<0.001。移植前患者血液透析时间长、肥胖、血浆CRP - hs水平高和AIP高是与移植肾功能延迟相关的独立因素,对肾移植后移植肾功能延迟具有预测价值,其中AIP具有良好的预测价值:曲线下面积(AUC)=0.859,p<0.001。

结论

移植肾功能延迟在活体供肾移植受者中较为常见。肾移植前的AIP是移植肾功能延迟的良好预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3800/11776492/d12d0b36d753/JCLA-39-e25142-g001.jpg

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