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在随访期间的多相EGFR轨迹和移植后的长期移植失败
Ruth Rahamimov1,2,3, Timna Agur1,3, Boris Zingerman1,3
1Department of Nephrology and Hypertension, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel.
Clinical transplantation
|September 24, 2023
概括
移植后功能发生的变化,称为估计膜过率 (eGFR) 轨迹,显著预测了移植的存活率. 改变的eGFR模式表明移植失败的风险更高.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 生物统计学 生物统计学
背景情况:
- 接受移植的接受者经常经历功能持续下降的情况.
- 然而,各种因素可以改变这种轨迹,影响移植的存活.
- 了解这些变化对于长期的移植管理至关重要.
研究的目的:
- 分析移植接受者估计的膜过率 (eGFR) 随着时间的推移而下降的模式.
- 调查改变的eGFR轨迹与移植存活率之间的关联.
主要方法:
- 估计的淋巴细胞过率 (eGFR) 是使用所有可用的肌素值从移植后的一年计算的.
- 采用零碎线性模型来分析eGFR轨迹模式.
- 患者数据包括988名接受者,随访时间中位数为5.2年.
主要成果:
- 超过30%的患者 (297/988) 呈现出多相EGFR轨迹.
- 在改变eGFR轨迹和增加移植失败风险之间发现了显著的关联 (HR 7.15,p < .001).
- 双相衰减模式在患有移植损失 (45.8%) 的患者中占主导地位.
结论:
- eGFR轨迹的变化是移植存活的重要预测因素.
- 监测eGFR模式可以了解移植损失的机制.
- 识别改变的轨迹可以帮助主动管理移植接受者.
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