AJKD:血浆铅浓度与晚期同种异体肾移植失败风险增加相关!

2022-06-27 liangying MedSci原创

肾移植前血浆铅浓度在移植后下降,与晚期同种异体肾移植衰竭的风险增加相关。

重金属会引起肾脏损伤,移植的肾脏尤其容易受到影响。最近的证据表明,血浆中重金属镉和砷的浓度与肾移植衰竭的风险增加有关。目前还不清楚这种关联是否也适用于血浆铅浓度。

本研究在荷兰格罗宁根(Groningen)的门诊对670例移植肾受者进行了为期1年的血浆铅浓度跟踪调查,随访时间约为5年。目的是探讨铅与肾移植受者(KTRs)的晚期移植失败是否潜在相关。

研究结果发现,在所有KTR中,中位基线血浆铅浓度为0.31μg/L(四分位间距,0.22-0.45)。在随访期间,78例(12%)KTR出现移植物衰竭。血浆铅浓度升高与移植失败风险增加相关(危险比, 1.59 [95% CI, 1.14-2.21),与年龄、性别、移植特征、估计的肾小球滤过率、蛋白尿、吸烟状况、酒精摄入和血浆镉砷浓度无关。在对饮食摄入进行额外调整后,这些结果基本保持不变,并与对铅进行分类检查的分析结果一致。在一系列测量中,移植患者入院时的血铅浓度明显高于移植后3个月时的血铅浓度(P=0.001),此后在2年的随访中,血铅浓度保持稳定(P=0.2)。

血浆铅浓度与肾移植受者移植物衰竭风险的关系

简单来说,本研究发现肾移植前血浆铅浓度在移植后下降,与晚期同种异体肾移植衰竭的风险增加相关。这些发现值得进一步研究,以评估降低血铅浓度的预防性或干预性治疗措施是否能降低肾移植失败率。

参考文献:Camilo G. Sotomayor, Flavia Giubergia, Dion Groothof, et al, Plasma Lead Concentration and Risk of Late Kidney Allograft Failure: Findings From the TransplantLines Biobank and Cohort Studies, American Journal of Kidney Diseases, Volume 80, Issue 1, 2022, Pages 87-97.e1, ISSN 0272-6386, https://doi.org/10.1053/j.ajkd.2021.10.009.

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