肝臓移植後の急性腎臓損傷から慢性腎臓疾患への進行の発生率とリスク要因: 遡及的なコホート研究
Liping Li1, Jinxuan Dai1,2, Yiqian Liu3
1Department of Anesthesiology, The Third Affiliated Hospital of SunYat-Sen University, Guangzhou City, Guangdong Province, China.
まとめ
肝臓移植患者の約30%が 急性腎臓損傷後に慢性腎臓病を発症します 糖尿病,がん,腎臓機能の低下は,この進行の主要な危険因子です.
科学分野:
- 腎臓科
- 移植医学
- 臨床流行病学
背景:
- 肝臓移植後の急性腎臓損傷 (AKI) は慢性腎臓病 (CKD) に繋がる可能性があります.
- 慢性腎臓病の進行により 死亡率,入院期間,医療費が増加します
- AKIからCKDの進行への危険因子を特定することは,患者のアウトカムにとって極めて重要です.
研究 の 目的:
- 肝臓移植後のCKDへの AKIの進行を調査する.
- AKIがCKDに進行する際の独立リスク要因を特定する.
主な方法:
- 肝臓移植後のAKIを患った443人の患者による遡及コホート研究.
- CKDと非 CKDのグループに分類する.
- リスク要因を決定するための多変量ロジスティック回帰分析
主要な成果:
- AKIは,患者の29. 3%でCKDに進行した.
- CKDの発症は1年後の死亡率 (4. 6%) と著しく高かった.
- 独立した危険因子には,手術前の糖尿病,肝臓の悪性腫瘍,上昇したSCr,AKDの移行/段階,低EGFRが含まれていた.
結論:
- AKIからCKDへの進行は肝臓移植後の大きな懸念です.
- 手術前の状態と 手術後の初期の腎臓機能は 重要な予測因子です
- 特定された危険因子をターゲットにすることで,CKDの発症を緩和し,長期的な生存率を向上させることができます.
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