不同性别、年龄活体供肾代偿能力的比较

肾脏病与透析肾移植杂志 ›› 2012, Vol. 21 ›› Issue (1): 14-18.

不同性别、年龄活体供肾代偿能力的比较

出版日期:2012-02-28 发布日期:2012-03-09

Comparing of graft kidney‘s compensation of glomerular filtration rate in elderly and female living kidney donors

Online:2012-02-28 Published:2012-03-09

摘要/Abstract

摘要：

摘要目的：检测不同性别、年龄组活体供肾肾移植前后肾小球滤过率（GFR）的变化，比较以上各组供肾代偿能力。方法：共84例活体肾移植供者，按其年龄分为老年组（>50岁)和非老年组（19～50岁)；按供者性别分为女性组和男性组。各组术前用MDRD公式计算总体肾小球滤过率(eGFR)，核素分别测定两侧GFR，按比例估算供肾术前的eGFR。计算受者移植后半年内最高eGFR。比较各组供肾eGFR移植前后变化情况。结果：总体供肾手术前后[ (54.78±13.50）ml/(min.1.73m2）vs（76.68±32.23）ml/(min.1.73m2) ]差异显著，代偿率32.30%（10.92%～63.89%）。老年组术后eGFR明显增加[（47.16±10.43）ml/(min.1.73m2) vs 66.15±17.89 ml/(min.1.73m2) ]，代偿率44.35%（18.16%～63.22%）。非老年组后eGFR代偿率30.52%（8.96%～63.01%）。男性组术后eGFR代偿率33.61% (14.77%～66.96%)。女性组术后eGFR代偿率25.66% (1.24%～62.45%)。供肾eGFR代偿率与其术前eGFR水平及受体年龄负相关。结论：移植后各组活体供肾eGFR均明显代偿性升高，但个体差异较大。虽然老年活体供肾eGFR水平在肾移植前后均较非老年活体供肾低，但其总体代偿能力良好。女性活体供肾与男性供体肾移植前后表现相近。术前评估活体供肾代偿能力要考虑其基础eGFR及受体需求。

关键词: 活体肾移植 , 边缘供肾 , 移植肾功能 , 肾小球滤过率 , 代偿率

Abstract:

ABSTRACT Objective: This study aimed to compare glomerular filtration rate (GFR) changes in the elderly and non-elderly, male and female living kidney donors before and after transplantation, and to further evaluate the compensation of GFR in each group. Methodology: Eighty four living kidney donors were divided into the male group (n=54) and female group (n=30), or elderly group (age over 50，n=25) and non-elderly group (n=59) .The total GFR was calculated with the MDRD formula, Meanwhile, bilateral GFR was determined by 99m TC-DTPA radionuclide assay, and then the preoperative estimated GFR (eGFR) of donor kidneys was calculated. Within half year following after operation, the maximum eGFR of graft kidneys was calculated and compared each group after operation. Results: The general eGFR of donor kidneys preoperatively was 54.8±13.5ml/(min×1.73m2), while 76.7±32.27ml/(min×1.73m2) postoperatively. The compensation rate of eGFR was 47.16%. In elderly group, the compensation rate of eGFR was 45.9±51.8%, while 44.9±69.8 % in non-elderly group. The compensation rate of eGFR was 41.9±40.4% in male group while 56.6±96.9% in female group. The compensation rate of eGFR was negatively correlated with preoperative eGFR and the age of recipients. Although the pre- and post-operative eGFR of living donor kidneys in the elderly group was both lower than non-elderly group, the eGFR in the elderly group and female group was well-compensated. Conclusion: After transplantation, the eGFR compensation rate of living donor kidneys was significantly elevated, but it was significant individuals. The pre- and post-operative parameters between female and male graft were similar, and thus preoperative evaluation on the compensation of living donor kidneys should carefully consider the basic eGFR and the needs of recipients.

Key words: living donor kidney transplantation , marginal donor , graft kidney function , glomerular filtration rate , compensation rate

孝晨，傅茜，刘龙山，等.. 不同性别、年龄活体供肾代偿能力的比较[J]. 肾脏病与透析肾移植杂志, 2012, 21(1): 14-18.

XIAO Chen，Fu Qian, LIU Long-shan, et al.. Comparing of graft kidney‘s compensation of glomerular filtration rate in elderly and female living kidney donors[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2012, 21(1): 14-18.

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