活体脏捐赠后高血压:发生率,预测因素和后果
João Fernandes1, José Silvano2,3,4, Sofia Pedroso2,3,4
1Department of Nephrology, Unidade Local de Saúde de Santo António (ULSdSA), Largo Professor Abel Salazar, Porto, 4099-001, Portugal. joaofernandes.nefrologia@chporto.min-saude.pt.
BMC nephrology
|November 11, 2025
概括
高血压发生在30%的活着的脏捐赠者身上,与更高的BMI和失脂症增加风险. 长期监测对于捐赠者的健康和功能保护至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 移植医学 移植医学
背景情况:
- 活体捐赠者 (LD) 移植对末期病 (ESKD) 是最优的.
- 包括高血压在内的LD的长期健康风险需要进一步定义.
- 了解捐赠后高血压对于捐赠者的安全至关重要.
研究的目的:
- 确定脏捐赠后高血压的发生率和预测因素.
- 评估捐赠后高血压和估计的球过率 (eGFR) 轨迹之间的关联.
- 为活着的脏捐赠者提供捐赠前咨询和捐赠后跟踪策略的信息.
主要方法:
- 对300名经过切除术的LD患者 (1998-2020年) 的回顾性队列研究,不包括那些捐赠前高血压患者.
- 随访时间平均为6.4年,监测新高血压 (血压>140/90毫米克或抗高血压疗法).
- 考克斯回归用于预测分析和线性混合效应模型用于eGFR关联.
主要成果:
- 高血压发生在30%的LD患者中;发病率在捐赠后5年达到21%,在捐赠后15年超过50%.
- 高血压的独立预测因素包括较高的BMI,脂质不良,以及捐赠前心压和心压升高的血压.
- 高血压与eGFR随着时间的推移 (-0.03毫升/分钟/年) 的适度但显著下降有关.
结论:
- 高血压是活着的脏捐赠者的常见并发症,与BMI和脂质不良症等可修改因素有关.
- 与高血压相关的功能下降是适度的,但需要注意.
- 长期监测和主动管理心血管风险因素对于活着的脏供体健康至关重要.
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