Altered kidney graft high-energy phosphate metabolism in kidney-transplanted end-stage renal disease type 1 diabetic patients - A cross-sectional analysis of the effect of kidney alone and kidney-pancreas transplantation
Altered kidney graft high-energy phosphate metabolism in kidney-transplanted end-stage renal disease type 1 diabetic patients - A cross-sectional analysis of the effect of kidney alone and kidney-pancreas transplantation
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DOI：
10.2337/dc06-1324
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发表时间：
2007-03-01
期刊：
影响因子：
16.2
通讯作者：
Del Maschio, Alessandro
中科院分区：
文献类型：
--
作者：
Fiorina, Paolo;Perseghin, Gianluca;Del Maschio, Alessandro
目的：糖尿病、高血压、血脂异常、肥胖、某些免疫抑制药物的肾毒性以及慢性同种免疫反应的持续性可能显著影响接受肾移植的终末期肾病（ESRD）I型糖尿病患者的移植物存活率。本研究的目的是确定肾单独（KD）或联合肾胰腺（KP）移植对肾能量代谢的影响。研究设计和方法-我们评估了高能磷酸盐（HEPs）代谢，通过使用，在一个横截面的方式，接受KD（n = 20）或KP（n = 20）的ESRD I型糖尿病移植患者的移植物中的P-31磁共振波谱在明显的慢性移植物肾病（CAN）出现之前很久就进行移植。选择10例非糖尿病微量白蛋白尿肾移植患者和10例非糖尿病肾移植患者作为对照组。（移植物能量状态的标志物）与其他组相比，β-ATP/Pi磷比值与AlC呈正相关，在分析中仅限于正常白蛋白尿患者亚组，与KD移植相比，在KP患者中仍然可以检测到β-ATP/Pi的差异。结论- KP移植比KD移植与更好的HEP相关，这表明β细胞功能的恢复积极影响肾移植物代谢。
OBJECTIVE - Diabetes, hypertension, dyslipidemia, obesity, nephrotoxicity of certain immunosuppressive drugs, and the persistence of a chronic alloimmune response may significantly affect graft survival in end-stage renal disease (ESRD) type I diabetic patients who have undergone kidney transplant. The aim of this study was to ascertain the impact of kidney alone (KD) or combined kidney-pancreas (KP) transplantation on renal energy metabolism.RESEARCH DESIGN AND METHODS - We assessed high-energy phosphates (HEPs) metabolism by using, in a cross-sectional fashion, P-31-magnetic resonance spectroscopy in the graft of ESRD type I diabetic transplanted patients who received KD (n = 20) or KP (n = 20) transplant long before the appearance of overt chronic allograft nephropathy (CAN). Ten nondiabetic microalbuminuric kidney transplanted patients and 10 nondiabetic kidney transplanted patients with overt CAN were chosen as controls subjects.RESULTS - Simultaneous KP transplantation patients showed a higher beta-ATP/inorganic phosphorus (Pi) ratio (marker of the graft energy status) versus the other groups, and a positive correlation between beta-ATP/Pi phosphorus ratio and AlC was found. in the analysis limited to the subgroup of normoalbuminuric patients, the difference in beta-ATP/Pi was still detectable in KP patients compared with KD transplantation.CONCLUSIONS - KP transplantation was associated with better HEPs than in KD transplantation, suggesting that restoration of beta-cell function positively affects kidney graft metabolism.