活体腎臓の提供後の高血圧と腎臓機能
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PubMedで要約を見る
まとめ
この要約は機械生成です。生きた腎臓の提供は高血圧やアルブミヌリアのリスクを増加させない. 手術後のeGFRの低下は遅くなりますが,長期的にはeGFRのレベルが低くなります.
科学分野
- 腎臓科
- 移植
- 公衆衛生
背景
- ガイドラインは,生きている腎臓提供者の長期的な健康上の結果に関する確固たる証拠の必要性を強調しています.
- 献血後のリスクの評価は 献血者の安全と情報に基づいた同意にとって極めて重要です
研究 の 目的
- 生きた腎臓のドナーの高血圧の発生率と 適合した非ドナーの高血圧の発生率を比較する.
- ドナーとノンドナーの間で推定されるグルメルフィルタレーション率 (eGFR) の低下とアルブミヌリアの割合の違いを評価する.
主な方法
- 生きた924人の腎臓ドナーと396人の非ドナーを対象とした前向きなコホート研究で,2004年から2014年の間に採用された.
- グループ間のベースラインの特徴をバランスするために,治療の逆の確率を重み付けました.
- フォローアップ評価は2021年11月まで毎年実施され,血圧,eGFR,アルブミヌリアのモニタリングが行われました.
主要な成果
- 高血圧の発生率は重み付け後にドナー (17%) とノンドナー (17%) の間で類似した (HR,1. 11; 95% CI,0. 75- 1. 66).
- ドナーは平均 eGFRの減少が遅い (1.4 mL/ min/ 1. 73 m2/ year未満) であったが,EGFRが30〜60 mL/ min/ 1. 73 m2 (47%対5%) であった可能性が高い.
- アルブミヌリアの割合は比較可能であった (ドナーでは15%,ノンドナーでは11%;HR,1. 46;95%CI,0. 97- 2. 21).
結論
- 生きた腎臓の提供は,非提供者と比較して高血圧またはアルブミヌリアのリスクの有意な増加と関連していません.
- 腎切除後のeGFRの減少は遅いですが,eGFRの減少を注意深くモニタリングする必要があります.
- この研究は,生きている腎臓提供者の長期的な健康状態に関する貴重なデータを提供します.
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