KIDNEY INT:活体肾脏捐献者捐赠后终末期肾病风险量化!

2017-07-02 xing.T MedSci原创

由此可见,风险估计对于适当的知情同意至关重要,并在活体肾捐赠者中有很大差别。更宽泛的条件可能对于老年黑人候选捐献者是必要的;年轻的黑人候选者应仔细评估。

有研究估计了美国活体供肾者捐献后发生ESRD的平均风险,但是在供体特征基础上的个性化估计仍无数据。近日,肾脏病领域权威杂志kidney international上发表了一篇研究文章,研究人员从1987年至2015年期间分析了133824名活体肾捐赠者,据器官移植和移植网络报道,研究人员通过医疗保险和医疗补助服务中心来确诊ESRD,使用Cox回归。

经过分析,研究人员发现黑人(风险比[HR]为2.96,95%可信区间[95%CI]为2.25-3.89,P<0.001)、男性(HR为1.88,95%CI为1.50-2.35,p<0.001)与捐赠者较高的ESRD风险相关。在非黑人捐献者中,年龄更大与更大的风险相关(每10年HR为1.40;95%CI为1.23-1.59;P<0.001)。在黑人捐赠者中,年龄较大与风险没有显著相关性(HR为0.88,95%CI为0.72-1.09;P=0.3)。更大的体重指数与较高的风险相关(每5公斤的HR为1.61,95%CI为1.29-2,P<0.001)。有一级生物学亲属关系接受者的捐赠者发生ESRD的风险增加(HR为1.70,95%CI为1.24-2.34;P<0.01)。模型C统计量为0.71。中期供者预测ESRD的风险为每10000例平均有34例,但1%的捐献者预测每10000名捐献者的风险超过256例。

由此可见,风险估计对于适当的知情同意至关重要,并在活体肾捐赠者中有很大差别。更宽泛的条件可能对于老年黑人候选捐献者是必要的;年轻的黑人候选者应仔细评估。

原始出处:

Allan B. Massie,et al. Quantifying Postdonation Risk of ESRD in Living Kidney Donors.kidney-international.2017. http://jasn.asnjournals.org/content/early/2017/06/30/ASN.2016101084.abstract

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    2017-07-04 圣艮山

    学习了不少事情!

    0

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    2017-07-04 gwc389
  7. [GetPortalCommentsPageByObjectIdResponse(id=1756938, encodeId=9a981e5693892, content=<a href='/topic/show?id=db7856538ee' target=_blank style='color:#2F92EE;'>#捐赠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56538, encryptionId=db7856538ee, topicName=捐赠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ce7f37274706, createdName=ms1692212821629096, createdTime=Tue Nov 21 12:08:00 CST 2017, time=2017-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1693457, encodeId=35f2169345e52, content=<a href='/topic/show?id=7e2de81588c' target=_blank style='color:#2F92EE;'>#终末期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78158, encryptionId=7e2de81588c, topicName=终末期)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1f6429431807, createdName=anminleiryan, createdTime=Mon Nov 20 02:08:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1758653, encodeId=d6ed1e58653ae, content=<a href='/topic/show?id=0fc55652546' target=_blank style='color:#2F92EE;'>#捐献#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56525, encryptionId=0fc55652546, topicName=捐献)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4b2a37353309, createdName=新生儿张玉军, createdTime=Mon Oct 09 21:08:00 CST 2017, time=2017-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218593, encodeId=939a218593ef, content=学习了不少事情!, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K4BGdu4COj6QWFqgMd3xnWDdgLZKUGI32veZvO2qFAQvpYr1eMbUOTqMvlZWc3MsugtFMHzxDwial/0, createdBy=88731939304, createdName=圣艮山, createdTime=Tue Jul 04 22:30:20 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476357, encodeId=a4c314e635732, content=<a href='/topic/show?id=eb69e81665d' target=_blank style='color:#2F92EE;'>#终末期肾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78166, encryptionId=eb69e81665d, topicName=终末期肾病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fb27278676, createdName=zengjiayao, createdTime=Tue Jul 04 03:08:00 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1603058, encodeId=9f67160305855, content=<a href='/topic/show?id=81b91049067' target=_blank style='color:#2F92EE;'>#kidney#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=19, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10490, encryptionId=81b91049067, topicName=kidney)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c36e18990621, createdName=gwc389, createdTime=Tue Jul 04 03:08:00 CST 2017, time=2017-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=217983, encodeId=a7ff21e9831a, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Mon Jul 03 06:53:17 CST 2017, time=2017-07-03, status=1, ipAttribution=)]
    2017-07-03 惠映实验室

    学习了,谢谢

    0

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