No evidence of accelerated loss of kidney function in living kidney donors:: Results from a cross-sectional follow-up
No evidence of accelerated loss of kidney function in living kidney donors:: Results from a cross-sectional follow-up
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DOI：
10.1097/00007890-200108150-00015
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发表时间：
2001-08-15
期刊：
影响因子：
6.2
通讯作者：
Elinder, CG
中科院分区：
文献类型：
--
作者：
Fehrman-Ekholm, I;Dunér, F;Elinder, CG
背景资料。可用于肾移植的肾脏缺乏，活体捐赠者的使用越来越多。重要的是要检查可能对捐献者的肾功能和血压的长期不利影响。从1964年到1995年，我们对我们中心所有在世的肾脏捐赠者进行了全面的随访。在仍然健在的402名捐献者中，我们能够使用试纸获得有关血肌酐、尿蛋白和尿中血细胞的信息，血压的信息比例为87%。使用公式估算肾小球滤过率(GFR)，并用碘海醇清除法测量43例供者的肾小球滤过率。将GFR和高血压患病率的个体数据与年龄和性别期望值进行比较。接受检查的供者的平均年龄为61岁(SD：13)，自捐献以来的时间为12年(SD：8)。平均估计的肾小球滤过率是年龄预测值的72%(SD：18)。肾小球滤过率的估计值与预测值的比值与供体后的时间无相关性，表明供体后未见肾功能的加速丧失。5例供者肾小球滤过率低于30ml/min。没有供者死于尿毒症，也没有人在死前接受过透析治疗。然而，三名捐赠者患上了肾脏疾病，一名捐赠者正在接受透析治疗。在其中两个病例中，可能涉及遗传因素。38%的献血者存在高血压，但年龄调整后的献血者高血压患病率并不高于普通人群。明显蛋白尿(大于或等于1.0g/L)占3%，轻度蛋白尿(
Background. There is a lack of kidneys available for kidney transplantation, and living donors are increasingly used. It is important to examine the possible long-term adverse affect on the renal function and blood pressure of the donors.Methods. We have made a comprehensive follow-up of all living kidney donors at our center from 1964 to 1995. Of 402 donors still alive, we were able to get information about serum creatinine, urinary proteins, and blood cells in urine using reagent strips, and blood pressure from 87%. The glomerular filtration rate (GFR) was estimated using a formula and was measured with Iohexol clearance in 43 of the donors. Individual data on GFR and the prevalence of hypertension were compared with the age- and gender-expected values.Results. The mean age of the examined donors was 61 years (SD:13) at follow-up, and the time since donation was 12 years (SD:8). The average estimated GFR was 72% (SD:18) of the age-predicted value. The ratio of the estimated to the predicted GFR showed no correlation to the time since donation, indicating that there is no accelerated loss of renal function after donation. GFR below 30 ml/min was found in five donors. No donor died in uremia or had dialysis treatment before death. However, three donors developed renal disease, and one was in dialysis treatment. In two of these cases, hereditary factors were possibly involved. Hypertension was present in 38% of the donors but the age-adjusted prevalence of hypertension among donors was not higher than in the general population. Significant proteinuria (greater than or equal to1.0 g/L) was found in 3% and slight proteinuria (