Proteinuria and reduced kidney function in living kidney donors: A systematic review, meta-analysis, and meta-regression
Proteinuria and reduced kidney function in living kidney donors: A systematic review, meta-analysis, and meta-regression
复制标题
DOI：
10.1038/sj.ki.5001819
复制
发表时间：
2006-11-01
影响因子：
19.6
通讯作者：
Boudville, N.
中科院分区：
文献类型：
--
作者：
Garg, A. X.;Muirhead, N.;Boudville, N.
我们回顾了任何一项研究，其中10名或更多的健康成年人捐赠了一个肾脏，至少一年后评估了蛋白尿或肾小球滤过率(GFR)。书目数据库一直搜索到2005年11月。31位主要作者提供了补充信息。来自27个国家的48项研究跟踪了总共5048名捐赠者。献血后平均7年(1~25年)，平均24 h尿蛋白定量154 mg/d，平均肾小球滤过率86ml/min。在8项报告了肾小球滤过率的研究中，12%的捐赠者的肾小球滤过率在30至59ml/min之间(范围0-28%)，0.2%的供者肾小球滤过率低于30ml/min(范围0-2.2%)。在对照研究中，供者的尿蛋白较高，且随着时间的推移变得更加明显(三项研究，共59名对照组和129名捐赠者；对照组83 mg/天，捐赠者147 mg/天，加权平均差66 mg/天，95%可信区间(CI)24-108)。肾小球滤过率在捐献后最初的下降并不伴随着比正常年龄预期的加速损失(6项研究，共189名对照组和239名捐赠者；对照组96ml/min，捐赠者84ml/min，加权平均差10ml/min，95%可信区间6~15；差异与捐献后时间无关(P=0.2))。捐献肾脏会导致尿蛋白略有增加。在最初的GFR减少之后，在随后的15年中不会出现加速的损失。未来的研究将提供更好的估计，并确定那些捐赠者至少有长期患病的风险。
We reviewed any study where 10 or more healthy adults donated a kidney, and proteinuria, or glomerular filtration rate (GFR) was assessed at least 1 year later. Bibliographic databases were searched until November 2005. 31 primary authors provided additional information. Forty-eight studies from 27 countries followed a total of 5048 donors. An average of 7 years after donation (range 1-25 years), the average 24 h urine protein was 154mg/day and the average GFR was 86 ml/min. In eight studies which reported GFR in categories, 12% of donors developed a GFR between 30 and 59 ml/min (range 0-28%), and 0.2% a GFR less than 30 ml/min (range 0-2.2%). In controlled studies urinary protein was higher in donors and became more pronounced with time (three studies totaling 59 controls and 129 donors; controls 83mg/day, donors 147mg/day, weighted mean difference 66mg/day, 95% confidence interval (CI) 24-108). An initial decrement in GFR after donation was not accompanied by accelerated losses over that anticipated with normal aging (six studies totaling 189 controls and 239 donors; controls 96 ml/min, donors 84ml/min, weighted mean difference 10 ml/min, 95% CI 6-15; difference not associated with time after donation (P = 0.2)). Kidney donation results in small increases in urinary protein. An initial decrement in GFR is not followed by accelerated losses over a subsequent 15 years. Future studies will provide better estimates, and identify those donors at least risk of long-term morbidity.