Guidi E, Cozzi M G, Minetti E, Bianchi G
Centro di Ricerca Clinical in Nefrologia e Ipertensione Arteriosa, Unità Operativa di Nefrologia, Dialisi e Terapia del Tranpianto Renale, Ospedale Niguarda Ca'Granda, Milano, Italy.
J Am Soc Nephrol. 1998 Nov;9(11):2102-7. doi: 10.1681/ASN.V9112102.
A previous historical prospective observational study, double blinded for knowledge of kidney donors' family history of hypertension, included 85 transplanted patients with stable renal function, not treated with cyclosporine, who were followed-up for an average of 8 yr and carefully characterized for the presence or absence of hypertension in the donor and recipient families. The recipients without a family history of hypertension, but grafted with a kidney coming from a "hypertensive" family, developed hypertension much more frequently than recipients grafted with a kidney coming from a "normotensive" family, or recipients with familial hypertension in whom the origin of the kidney did not influence the prevalence of hypertension after transplantation. In this second study of the same patients, it was found that these recipients with a "normotensive" family and a "hypertensive" kidney showed a greater increase of diastolic BP (P = 0.005) and a greater degree of acute renal damage (P = 0.004) during acute rejections than all of the other recipients. This extension study shows that a grafted kidney can transmit not only chronic hypertension, but also susceptibility to a greater rise in BP and more severe kidney impairment after an acute insult.
一项既往的历史性前瞻性观察性研究，对肾脏供体家族高血压病史情况进行双盲处理，纳入了85例肾功能稳定、未接受环孢素治疗的肾移植患者，平均随访8年，并对供体和受体家族中高血压的有无进行了仔细评估。无高血压家族史但接受来自“高血压”家族肾脏移植的受体，比接受来自“血压正常”家族肾脏移植的受体，或有家族性高血压且肾脏来源不影响移植后高血压患病率的受体，更频繁地发生高血压。在对同一批患者的第二项研究中发现，这些具有“血压正常”家族史和“高血压”肾脏的受体，在急性排斥反应期间，舒张压升高幅度更大（P = 0.005），急性肾损伤程度更严重（P = 0.004），高于所有其他受体。这项扩展研究表明，移植肾不仅可以传递慢性高血压，还可以传递急性损伤后血压更大幅度升高和更严重肾脏损害的易感性。
