Kidney Failure After Heart Transplantation
Kidney Failure After Heart Transplantation
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DOI：
10.1016/j.transproceed.2010.05.049
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发表时间：
2010-10-01
影响因子：
0.9
通讯作者：
Lage Galle, E.
中科院分区：
文献类型：
--
作者：
Escoresca Ortega, A. M.;de Azua Lopez, Z. Ruiz;Lage Galle, E.
背景和目的。心脏移植是一种死亡率很高的手术。心脏移植后肾功能改变（AKF）很常见。本研究的目的是确定2006年1月至2008年11月期间在我院接受心脏移植的患者中肾功能不全的发生率及其相关因素。患者和方法。这项回顾性观察研究对 2006 年 1 月 1 日至 2008 年 11 月 15 日期间接受心脏移植的所有患者进行。记录了以下变量：患者合并症、适应症、术前尿素和肌酐水平、供体变量、手术过程和术后特征。结果。总共进行了54例心脏移植，其中68.5%的患者是男性。移植时的平均年龄为 49.52 岁（+/-13.45 岁），平均体重为 72.5 公斤（+/-14.8 公斤）。总死亡率为28.30%。 54 名患者中，70.4% 在移植后第一周出现 AKF；根据急性肾损伤分类，30.61% 处于 III 期。除了体外手术时间（AKF 患者明显较长）和血糖（术后即刻较高）之外，肾衰竭患者组与非肾衰竭患者组之间没有统计学上的显着差异。患者死亡率分析显示 AKF 患者的死亡率没有显着差异（80% vs 68.4%；P = 31）。结论。急性肾衰竭的发生率很高（70.4%），慢性肾脏替代疗法的使用率也很高（28.85%），但随着时间的推移，急性肾衰竭的发生率显着下降。
Background and purpose. Heart transplantation is a procedure with a high mortality rate. Altered kidney function (AKF) after a heart transplant is common. The purpose of this study was to determine the incidence of and associated factors for renal dysfunction among patients who underwent heart transplantation in our hospital between January 2006 and November 2008.Patients and methods. This retrospective observational study was performed on all patients receiving a heart transplant between January 1, 2006 and November 15, 2008. The following variables were recorded: patient comorbidities, indication, presurgical urea and creatinine levels, donor variables, surgical procedure, and postoperative features.Results. A total of 54 heart transplantations were performed with 68.5% of patients being male. The average age at transplant was 49.52 years (+/-13.45 y) and the mean weight 72.5 kg (+/-14.8 kg). Overall mortality was 28.30%. Of the 54 patients, 70.4% showed AKF during the first week after transplantation; 30.61% were in stage III according to the Acute Kidney Injury classification. There were no statistically significant differences between the group of patients with versus without renal failure, except for the extracorporeal surgery time, which was significantly longer among those patients who had AKF, and glycemia, which was also higher in the immediate postoperative period. Analysis of patient mortality showed no significant differences for the patients with AKF (80% vs 68.4%; P = 31).Conclusions. The rate of acute kidney failure was high (70.4%), as was the use of chronic renal replacement therapy (28.85%), but it decreased considerably when followed over time.