生きた腎臓のドナーによる末期性腎疾患のリスク
Abimereki D Muzaale1, Allan B Massie1, Mei-Cheng Wang2
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA
|February 13, 2014
まとめ
腎臓のドナーは,健康なノンドナーと比較して,末期腎疾患 (ESRD) のリスクがわずかに高くなります. しかし,腎臓のドナーに対するESRDリスクの絶対的な増加は小さいため,寄付決定に情報を与えることができます.
科学分野:
- ネフロロジーはネフロロジーを用います.
- 移植手術 移植手術について
- 公衆衛生は公衆衛生である.
背景:
- 以前の腎臓提供者における末期腎疾患 (ESRD) リスクの比較では,高リスクでスクリーニングされていない個人を含む一般人数を用いた.
- より正確なリスク評価には,腎臓ドナーと,同様のスクリーニングを受けた健康な非ドナーコホートとの比較が必要です.
研究 の 目的:
- 腎臓ドナーと健康な非ドナーコホート間のESRDリスクを比較する.
- ESRDのリスクを患者の人口統計によって層分化するために.
主な方法:
- 96,217人の腎臓ドナーと20,024人の健康な非ドナー (NHANES III) のコホートは,メディケアデータとリンクされた.
- 末期腎疾患 (ESRD) は,透析開始,待合者リストの配置,または移植受付によって定義されました.
- フォローアップは15年延長され,ドナー群のフォローアップ期間の中央値は7.6年,ノンドナー群のフォローアップ期間は15年であった.
主要な成果:
- 15年後には,腎臓提供者のESRDリスクは1万人に30.8であったが,健康な非提供者の場合は1万人に3.9であった (P < .001).
- このリスクの増加は,白人と黒人の両方で観察されました.
- 推定された生涯ESRDリスクは,健康なノンドナー1万人に14人に対して,10,000人のドナーに90人でした.
結論:
- 腎臓のドナーは,マッチングした健康なノンドナーと比較して,ESRDのリスクが高くなります.
- 腎臓提供者のESRDリスクの絶対的な増加は小さい.
- 発見は,生きている腎臓の寄付のリスクと利益に関する議論を参考にすることができます.
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