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年龄和性别对肾移植供体肾功能的影响:一项前瞻性研究。

Effect of age and gender on kidney function in renal transplant donors: a prospective study.

作者信息

Sesso R, Whelton P K, Klag M J

机构信息

Welch Center for Prevention, School of Medicine, Johns Hopkins University, Baltimore, Maryland.

出版信息

Clin Nephrol. 1993 Jul;40(1):31-7.

PMID:8358873
Abstract

We evaluated the long-term residual renal function in 64 living related kidney donors. Our main objective was to identify baseline factors, including gender and age, that could predict renal impairment after nephrectomy. Forty-four (69%) of the 64 donors were women. The mean +/- SEM age of those studied was 36 +/- 1.3 years and their mean +/- SEM duration of follow-up was 62 +/- 4.9 months (range, 6 to 174). Overall mean serum creatinine concentration after kidney donation was increased compared to baseline values (1.13 mg/dl vs 0.92 mg/dl, respectively, p < 0.001). At the last follow-up visit, post-nephrectomy mean glomerular filtration rate (GFR) values, adjusted for body surface area, age at donation, baseline serum creatinine and duration of follow-up, measured by 99mTc-DTPA were significantly lower in women than in men (72.11 ml/min vs 87.17 ml/min, respectively, p = 0.02). At follow-up, mean effective renal plasma flow, adjusted for the same variables, measured by 131I-hippuran was also significantly lower in women compared to men (318.07 ml/min vs 400.82 ml/min, respectively, p < 0.01). Eleven of twelve patients with post-nephrectomy GFR values less than 60 ml/min were women. Following nephrectomy, serum creatinine concentration increased significantly as a function of greater age at donation in women but not in men. Similarly, in women but not in men, follow-up GFR measurements decreased significantly as a function of age after adjusting for baseline serum creatinine and duration of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们评估了64名活体亲属肾供体的长期残余肾功能。我们的主要目标是确定能够预测肾切除术后肾功能损害的基线因素,包括性别和年龄。64名供体中有44名(69%)为女性。研究对象的平均年龄±标准误为36±1.3岁,平均随访时间±标准误为62±4.9个月(范围6至174个月)。与基线值相比,肾移植术后总体平均血清肌酐浓度有所升高(分别为1.13mg/dl和0.92mg/dl,p<0.001)。在最后一次随访时,经99mTc-DTPA测量,调整体表面积、供体年龄、基线血清肌酐和随访时间后,女性肾切除术后的平均肾小球滤过率(GFR)值显著低于男性(分别为72.11ml/min和87.17ml/min,p=0.02)。随访时,经131I-马尿酸测量,调整相同变量后,女性的平均有效肾血浆流量也显著低于男性(分别为318.07ml/min和400.82ml/min,p<0.01)。肾切除术后GFR值低于60ml/min的12名患者中有11名是女性。肾切除术后,女性血清肌酐浓度随供体年龄的增加而显著升高,而男性则不然。同样,在调整基线血清肌酐和随访时间后,女性的随访GFR测量值随年龄的增加而显著降低,而男性则不然。(摘要截选至250字)

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