免疫抑制和与移植相关的特征影响了基于肌素的eGFR方程与素C之间的差异,在接受脏移植的接受者中
Lukas Weidmann1, Catherine Laux1, Kai Castrezana Lopez1
1Department of Nephrology, University Hospital of Zurich, Zurich, Switzerland.
Clinical kidney journal
|November 6, 2024
概括
估计的淋巴细胞过率 (eGFR) 方程显示了移植接受者 (KTR) 的变化. 移植因素,如贝拉塔塞普或普雷迪尼松使用,影响基于肌素 (eGFRcr) 和基于囊素C (eGFRcys) 的EGFR测量之间的差异.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植医学 移植医学
- 生物标记分析 生物标记分析
背景情况:
- 估计的淋巴细胞过率 (eGFR) 方程在移植接受者 (KTR) 中呈现异质性.
- 关于移植特征如何影响基于肌素 (eGFRcr) 和囊素C (eGFRcys) 的eGFR方程的研究有限.
研究的目的:
- 在KTRs中全面分析和比较各种eGFRcr和eGFRcys方程.
- 确定影响eGFRcr和eGFRcys之间的差异的移植相关特征.
主要方法:
- 使用三个eGFRcr方程 (CKD-EPI 2009,EKFC 2021,KRS-GFR 2023) 和两个eGFRcys方程 (CKD-EPI 2012,EKFC 2023) 对596个KTR进行分析.
- 使用布兰德-阿尔特曼图表来评估eGFR阶段之间的相对差异.
- 采用多变量逻辑回归来确定与eGFRcr/eGFRcys差异相关的独立因素.
主要成果:
- 平均eGFR在方程之间变化高达9毫升/分钟/1.73平方米.
- 在比较eGFRcr与CKD-EPI 2012年eGFRcys与EKFC 2023年eGFRcys时,相对差异较大 (P <.001).
- 活体捐赠和贝拉塔塞普使用与较小的eGFRcr/eGFRcys差异相关,而普雷尼松和更高的HbA1c与更大的差异有关.
结论:
- 对于eGFRcr/eGFRcys的影响,eGFR阶段,捐赠/接受因子和免疫抑制剂 (贝拉塔塞普,普雷尼松) 对KTRs的差异产生影响.
- 这些影响因素必须在接受移植患者的临床管理中考虑.
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