Chronic renal failure after transplantation of a nonrenal organ
Chronic renal failure after transplantation of a nonrenal organ
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DOI：
10.1056/nejmoa021744
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发表时间：
2003-09-04
影响因子：
158.5
通讯作者：
Merion, RM
中科院分区：
文献类型：
--
作者：
Ojo, AO;Held, PJ;Merion, RM
背景：非肾性器官移植常并发慢性肾脏病，其病因复杂多样。我们进行了一项基于人群的队列分析，以评估慢性肾衰竭的发病率、危险因素以及非肾移植受者的相关死亡风险。方法：为了估计慢性肾功能衰竭的累积发生率，将移植前和移植后的临床变量和终末期肾病（ESRD）患者登记数据联系起来（定义为肾小球滤过率为29 ml/min/1.73 m2体表面积或更少或发展为终末期肾病）和相关死亡风险，研究对象为1990年至2000年间在美国接受非肾移植的69，321人。在平均36个月的随访期间，11,426名患者（16.5%）发生了慢性肾衰竭。在这些患者中，3297例（28.9%）需要维持性透析或肾移植。慢性肾衰竭的五年风险根据移植器官的类型而变化-从心肺移植接受者的6.9%到肠移植接受者的21.3%。多因素分析表明慢性肾功能衰竭的风险增加与年龄增加有关（每10岁增加的相对风险为1.36; P
Background: Transplantation of nonrenal organs is often complicated by chronic renal disease with multifactorial causes. We conducted a population-based cohort analysis to evaluate the incidence of chronic renal failure, risk factors for it, and the associated hazard of death in recipients of nonrenal transplants.Methods: Pretransplantation and post-transplantation clinical variables and data from a registry of patients with end-stage renal disease (ESRD) were linked in order to estimate the cumulative incidence of chronic renal failure (defined as a glomerular filtration rate of 29 ml per minute per 1.73 m(2) of body-surface area or less or the development of ESRD) and the associated risk of death among 69,321 persons who received nonrenal transplants in the United States between 1990 and 2000.Results: During a median follow-up of 36 months, chronic renal failure developed in 11,426 patients (16.5 percent). Of these patients, 3297 (28.9 percent) required maintenance dialysis or renal transplantation. The five-year risk of chronic renal failure varied according to the type of organ transplanted -- from 6.9 percent among recipients of heart-lung transplants to 21.3 percent among recipients of intestine transplants. Multivariate analysis indicated that an increased risk of chronic renal failure was associated with increasing age (relative risk per 10-year increment, 1.36; P