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与肝移植相关的损伤
María Azpilicueta-Idarreta1, María Prieto-Torre2, Lucía Montijano-Herrero3
1Unit de Nefrología Pediátrica, Hospital Universitario Reina Sofía, Córdoba, Spain.
Anales de pediatria
|August 19, 2023
概括
估计肝移植后儿童的功能是复杂的. 施瓦茨公式可能会低估慢性病 (CKD) 的诊断,强调需要多个GFR公式和损伤标志物.
科学领域:
- 儿科脏病学 儿科脏病学
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
背景情况:
- 损伤是接受肝移植 (LT) 的儿童常见的并发症.
- 对功能,特别是慢性病 (CKD) 的准确评估在这个人群中具有挑战性.
- 术后急性损伤 (AKI) 和长期CKD需要仔细评估.
研究的目的:
- 分析儿科LT接受者的术后AKI的发生率.
- 用各种膜过率 (GFR) 估计公式来确定CKD的患病率.
- 在这个队列中确定与CKD相关的风险因素.
主要方法:
- 儿科患者 (<18岁) 经过LT的横截面研究,随访时间中位数为5.42年.
- 使用Schwartz (2009),CAPA (cystatin C) 和Pottel的FAS组合公式进行GFR估计.
- 使用布兰德-阿尔特曼和卡帕统计数据分析配方之间的一致性;测量尿蛋白和血压.
主要成果:
- 包括52名患者;28.8%的患者经历过AKI. 10%的人患有CKD,LT期间的急性肝衰竭是唯一的风险因素 (OR 8.57,P = 0.04).
- 在GFR估计公式之间观察到差的一致性,与CAPA和FAS相比,Schwartz公式低估了CKD患病率.
- 42%未被诊断为CKD的儿童表现出损伤的其他标志物.
结论:
- 仅依靠2009年施瓦茨公式可能会导致儿科LT患者的CKD诊断不足.
- 使用多个GFR估计公式对于准确的CKD评估至关重要.
- 检测额外的损伤标志物对于预防LT后CKD进展至关重要.
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