Kujawa-Szewieczek Agata, Słabiak-Błaż Natalia, Kolonko Aureliusz, Więcek Andrzej, Piecha Grzegorz
Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, Poland.
J Clin Med. 2025 Mar 29;14(7):2346. doi: 10.3390/jcm14072346.
: The suitability of the Kidney Donor Risk Index (KDRI) has not been fully validated in the European population. The aim of this study was to evaluate the value of the KDRI in predicting kidney graft function and cardiovascular events (CVEs) in a Polish cohort of kidney transplant recipients (KTRs). : In this retrospective study kidney graft function and CVEs were analyzed among 1420 patients transplanted between 1999 and 2017 and followed until 2021. The KDRI was calculated according to the formula proposed by Rao. Patients were assigned into quartiles (Qs) of KDRI values. : Patients in Q4 were older, with higher BMI, longer cold ischemia time (CIT), and a greater rate of ischemic heart disease at the transplantation. The KDRI value determined both early and long-term graft function. During a median follow-up period of 91 months, at least one cardiovascular event was noted in 227 (16.0%) kidney transplant recipients. There was a significant increasing trend for the occurrence of post-transplant CV complications along the consecutive KDRI quartiles (χ = 7.3; < 0.01) among kidney transplant patients younger than 50 years at the time of transplantation. : The KDRI is an adequate prognostic tool also for the European population. Despite the KDRI not being used for allocation in Poland we found that kidneys with a higher KDRI are allocated to recipients with worse survival prognosis. The quality of kidneys from a deceased donor may be related to the occurrence of post-transplant cardiovascular complications in recipients younger than 50 years at the transplantation, including those without history of comorbidities such as diabetes or cardiovascular disease.
肾脏供体风险指数（KDRI）在欧洲人群中的适用性尚未得到充分验证。本研究的目的是评估KDRI在预测波兰肾移植受者（KTRs）队列中肾移植功能和心血管事件（CVE）方面的价值。：在这项回顾性研究中，分析了1999年至2017年间接受移植并随访至2021年的1420例患者的肾移植功能和CVE。KDRI根据Rao提出的公式计算。患者被分为KDRI值的四分位数（Qs）。：四分位数4中的患者年龄较大，体重指数较高，冷缺血时间（CIT）较长，移植时缺血性心脏病发生率较高。KDRI值决定了早期和长期的移植功能。在中位随访期91个月期间，227例（16.0%）肾移植受者中至少记录到一次心血管事件。在移植时年龄小于50岁的肾移植患者中，移植后心血管并发症的发生率沿连续的KDRI四分位数有显著增加趋势（χ = 7.3；<0.01）。：KDRI也是欧洲人群适用的预后工具。尽管KDRI在波兰未用于分配，但我们发现KDRI较高的肾脏被分配给生存预后较差的受者。来自已故供体的肾脏质量可能与移植时年龄小于50岁的受者移植后心血管并发症的发生有关，包括那些没有糖尿病或心血管疾病等合并症病史的受者。
