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低估计的膜过率的后果,无论是在脏捐赠之前还是脏捐赠后的早期
Michael D Evans1, Erika S Helgeson2, Andrew D Rule3
1Clinical and Translational Science Institute, University of Minnesota, Minneapolis, Minnesota, USA.
概括
在脏捐赠前或之后,低估计的球过率 (eGFR) 会增加患慢性病 (CKD) 3b和4阶段的风险. 捐赠后的eGFR是主要的风险驱动因素,与心血管疾病,高血压,糖尿病或死亡无关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 公共卫生 公共卫生
背景情况:
- 降低膜过率 (GFR) 与慢性病 (CKD),心血管疾病 (CVD) 和一般人群的死亡率有关.
- 活体脏捐赠者低估GFR (eGFR) 相关的风险,无论是捐赠前还是捐赠后,仍然不清楚.
研究的目的:
- 调查预捐和早期捐后EGFR之间的关联,以及在活着的脏捐赠者中发展CKD3b和4阶段,高血压,糖尿病 (DM),心血管疾病和死亡的长期风险.
主要方法:
- 分析了来自1699名活着的脏捐赠者的数据,其中包括可用的先前捐赠和早期捐赠后的eGFR测量.
- 纵向研究追踪时间到持续的eGFR<45mL/min/1.73m2 (CKD阶段3b) 和<30mL/min/1.73m2 (CKD阶段4),以及高血压,DM,心血管疾病和死亡的发生率.
- 随访时间中位数为12年 (四分位数范围,6-21年).
主要成果:
- 20年事件率包括5.8%的eGFR<45,1.2%的eGFR<30,高血压的29.0%,DM的7.8%,心血管疾病的8.0%,死亡的5.2%.
- 低预捐和早期捐后的eGFR都与发展eGFR<45和eGFR<30有关.
- 低后捐赠eGFR,而不是前捐赠eGFR,是降低eGFR风险的主要驱动因素,但这两者都与高血压,DM,心血管疾病或死亡有关.
结论:
- 低预捐和早期捐后EGFR是活着的脏捐赠者中发展晚期CKD (3b和4阶段) 的重要风险因素.
- 慢性病进展的风险主要受捐后eGFR水平的影响.
- 活体脏捐赠似乎不会增加患高血压,DM,CVD或死亡的风险,基于eGFR水平.
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