Assessment of renal function in type I diabetic patients after kidney, pancreas, or combined kidney-pancreas transplantation.
Assessment of renal function in type I diabetic patients after kidney, pancreas, or combined kidney-pancreas transplantation.
复制标题
肾、胰或肾胰联合移植后 I 型糖尿病患者的肾功能评估。
DOI：
10.1097/00007890-199106000-00008
复制
发表时间：
1991
期刊：
影响因子：
6.2
通讯作者：
Dunn,DL
中科院分区：
文献类型：
--
作者：
Morel,P;Sutherland,DE;Almond,PS;Stöblen,F;Matas,AJ;Najarian,JS;Dunn,DL
对接受功能至少1年的膀胱引流的同种异体移植的62例患者的长期肾功能(KF)进行了为期两年的连续研究。53名患者(85%)在移植后1个月、42名(68%)在移植后1年、16名(26%)在移植后2年接受分析。在每个受者类别内和类别之间进行KF的比较。此外，SPK和PAK患者的KF与1型糖尿病单独接受KTX治疗(功能至少1年)的匹配组进行了比较。SPK组KF随时间变化稳定：1个月时平均+/-SD血肌酐(mg/dl)为1.5+/-0.5，1年时为1.8+/-1.0，2年时为1.7+/-0.5。在PAK类型中，PTX前的血肌酐为1.4+/-0.5，PTX后保持稳定(1个月1.3+/-0.2，1年1.3+/-0.4，2年1.2+/-0.4)。PTA组术后1个月(1.1+/-0.4)、1年(1.4+/-0.5)、2年(1.3+/-0.5)评分明显高于PTA前(0.9+/-0.2)(P<；=0.03)，1个月、2年评分低于1年评分，与1个月评分比较差异有统计学意义(P=0.01)。PTX组患者PTX前评分(0.9+/-0.2)显著低于PAK组(1.4+/-0.5)(P=0.01)。1个月时PTA组(1.1+/-0.4)较SPK组(1.5+/-0.5)显著降低(P=0.02)，但此后(1年和2年)差异无统计学意义(P>；0.1)。与SPK和PAK类别相比，单独使用KTX的受试者在TX后的每个时间点的KF相似。我们的结论是，糖尿病患者可以进行PTX，而不会对同期或先前移植的肾脏产生不良影响，并且在统计上显著的、尽管轻微到中度的、初始的、但不是进行性的自然肾功能恶化发生在单独接受PTX的患者中。
The long-term kidney function (KF) in the three categories of diabetic type 1 pancreas (P) transplant recipients (simultaneous P and kidney [SPK]; P after K [PAK]; PTx alone [PTA]) was studied sequentially over a 2-year period in 62 patients who received a bladder-drained allograft that functioned for at least 1 year. Fifty-three (85%) patients were analyzed at 1 month, 42 (68%) at 1 year, and 16 (26%) at 2 years posttrans-plant. Comparison of KF was made within each recipient category and between categories. In addition, the KF in the SPK and PAK patients was compared to a matched group of diabetic type 1 recipients of KTx alone (functioning at least 1 year). In the SPK group, KF was stable over time: the mean+/-SD serum creatinine (mg/dl) was 1.5+/-0.5 at 1 month, 1.8+/-1.0 at 1 year, and 1.7+/-0.5 at 2 years. In the PAK category, the pre-PTx serum creatinine value was 1.4+/-0.5, and then remained stable after the PTx (1.3+/-0.2 at 1 month, 1.3+/-0.4 at 1 year, and 1.2+/-0.4 at 2 years). In the recipients of a PTA, the values at 1 month (1.1+/-0.4), 1 year (1.4+/-0.5), and 2 years (1.3+/-0.5) were significantly higher (P<= 0.03) than the pre-PTx value (0.9+/-0.2); and results at 1 month and 2 years were lower than those at 1 year, a significant difference compared to the 1-month value (P= 0.01). Comparisons between the categories of PTx recipients demonstrated that the pre-PTx value in the PTA group (0.9+/-0.2) was significantly lower (P= 0.01) than in the PAK group (1.4+/-0.5). At 1 month the serum creatinine value in the PTA category (1.1+/-0.4) was significantly lower (P= 0.02) than in the SPK category (1.5+/-0.5), but thereafter (1 and 2 years) the difference was not significant (P> 0.1). KF in recipients of KTx alone was similar at each post-Tx time point when compared to the SPK and PAK categories. We concluded that a PTx can be performed in diabetics without a detrimental effect on a simultaneously or a previously transplanted kidney and that a statistically significant, albeit minimal to moderate, initial but not progressive deterioration in native KF occurs in recipients of a PTx alone.