Impact of Remote Ischemic Preconditioning Conducted in Living Kidney Donors on Renal Function in Donors and Recipients Following Living Donor Kidney Transplantation: A Randomized Clinical Trial
Impact of Remote Ischemic Preconditioning Conducted in Living Kidney Donors on Renal Function in Donors and Recipients Following Living Donor Kidney Transplantation: A Randomized Clinical Trial
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DOI：
10.3390/jcm8050713
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发表时间：
2019-05-01
影响因子：
3.9
通讯作者：
Song, Jun-Gol
中科院分区：
文献类型：
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作者：
Bang, Ji-Yeon;Kim, Sae-Gyeol;Song, Jun-Gol
尽管远程缺血预处理（RIPC）已被证明具有肾保护作用，但很少有研究评估RIPC对活体肾供者肾功能的影响。本研究调查了活体肾供者的RIPC是否能改善供者的残余肾功能和肾移植后受者的预后。将供体随机分为对照组（n = 85）和RIPC组（n = 85）。根据匹配的供体纳入受赠人。比较对照组和RIPC组供体和受体的血清肌酐（sCr）浓度和肾小球滤过率（eGFR）。对受者进行移植后一年内延迟移植功能、急性排斥反应和移植物衰竭的评估。对照组的sCr（平均1.13；95%可信区间（CI） 1.07-1.18）在出院时显著高于RIPC组（1.01;95% CI, 0.95-1.07） （p = 0.003）。1年后，出院时血清肌酐bb0 1.4 mg/dL的供者慢性肾病患病率（n = 6, 26.1%）高于血清肌酐水平正常的供者（n = 8, 5.4%） （p = 0.003）。在一年的随访期间，RIPC组和对照组的sCr浓度和eGFR相似。在接受者中，在RIPC组和对照组中没有明显的结果变量差异。RIPC对肾脏供者早期肾功能改善有效，但对受者肾功能无改善作用。
Although remote ischemic preconditioning (RIPC) has been shown to have renoprotective effects, few studies have assessed the effects of RIPC on renal function in living kidney donors. This study investigated whether RIPC performed in living kidney donors could improve residual renal function in donors and outcomes in recipients following kidney transplantation. The donors were randomized into a control group (n = 85) and a RIPC group (n = 85). The recipients were included according to the matched donors. Serum creatinine (sCr) concentrations and estimated glomerular filtration rate (eGFR) were compared between control and RIPC groups in donors and recipients. Delayed graft function, acute rejection, and graft failure within one year after transplantation were evaluated in recipients. sCr was significantly increased in the control group (mean, 1.13; 95% confidence interval (CI), 1.07-1.18) than the RIPC group (1.01; 95% CI, 0.95-1.07) (p = 0.003) at discharge. Donors with serum creatinine >1.4 mg/dL at discharge had higher prevalence of chronic kidney disease (n = 6, 26.1%) than donors with a normal serum creatinine level (n = 8, 5.4%) (p = 0.003) after one year. sCr concentrations and eGFR were similar in the RIPC and control groups of recipients over the one-year follow-up period. Among recipients, no outcome variables differed significantly in the RIPC and control groups. RIPC was effective in improving early renal function in kidney donors but did not improve renal function in recipients.