Endothelial Dysfunction Is Associated With Graft Loss in Renal Transplant Recipients
Endothelial Dysfunction Is Associated With Graft Loss in Renal Transplant Recipients
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DOI：
10.1097/tp.0b013e31827d6312
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发表时间：
2013-03-15
期刊：
影响因子：
6.2
通讯作者：
Asberg, Anders
中科院分区：
文献类型：
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作者：
Dahle, Dag Olav;Midtvedt, Karsten;Asberg, Anders
背景内皮功能障碍在肾移植受者中普遍存在，但其与移植物丢失或死亡率的关系尚不确定。自1997年以来，我们在几个小型试验中采用前臂激光多普勒血流仪无创地测量了内皮功能。合并这些检测用于当前分析。我们使用考克斯比例风险模型来调整患者和移植物的特征。由于在移植后90天之前或之后进行的测试之间存在显著异质性，因此分别对这些进行检查。在移植后90天检查的175例患者中，内皮功能评分低于中位数预测移植物丢失，（风险比[HR]，1.85 [1.09-3.16]; P=0.02）和死亡删失的移植物丢失（HR，2.63 [1.18-5.84]; P=0.02），但非全因死亡率（HR，1.20 [0.62-2.30]; P=0.58）。在移植后90天前检查的140例患者中，未发现相关性。移植后90天以上发现的内皮功能障碍与移植肾丢失有关。
Background. Endothelial dysfunction is prevalent in renal transplant recipients, but it is uncertain if there is an association with graft loss or mortality.Methods. Since 1997, we have measured endothelial function noninvasively by forearm laser Doppler flowmetry in several small trials. These tests were pooled for the current analysis. We used Cox proportional hazard models to adjust for patient and graft characteristics. Due to significant heterogeneity between tests conducted before or after day 90 after transplantation, these were examined separately.Results. In the 175 patients examined after day 90 after transplantation, an endothelial function score below the median predicted graft loss (hazard ratio [HR], 1.85 [1.09-3.16]; P=0.02) and death-censored graft loss (HR, 2.63 [1.18-5.84]; P=0.02) but not all-cause mortality (HR, 1.20 [0.62-2.30]; P=0.58). In 140 patients examined before day 90 after transplantation, no association was found.Conclusion. Endothelial dysfunction identified more than 90 days after transplantation was associated with renal graft loss.