活体肾移植供肾切除术对供体早期肾功能的影响

目的 分析活体肾移植供肾切除术对供体肾功能早期的影响.方法 回顾性分析本中心自2010年4月至2014年11月467例活体供肾者的临床资料,提取肾切除术前,术后3d、7d、1个月、3个月时的血肌酐、肾小球滤过率(GFR)、尿酸、尿微量蛋白数据,了解肾切除术对供体早期肾功能的影响.结果 活体供肾者术前,术后3d、7d、1个月、3个月时的血肌酐(Scr)分别为(59.9± 12.8)、(85.8±21.0)、(91.2±21.3)、(92.8±21.6)、(91.0±21.3) μmol/L;肾小球滤过率(GFR)分别为(113.5±25.3)、(75.1±17.9)、(70.3±15.2)、(68.5±16.0)、(69.5±15.1) ml/min;血尿酸(Ua)分别为(292.60±79.58)、(142.18±55.28)、(228.41±66.39)、(321.31±83.72)、(346.61±87.21)μmol/L;术后与术前相比上述指标差异均有统计学意义(P＜0.05).术后各时间点尿IgG、微量白蛋白、视黄醇结合蛋白、β2微球蛋白与术前相比差异均有统计学意义(P＜0.05).结论 活体供肾切除术早期明显影响供体肾小球滤过率、尿酸及尿微量蛋白,临床需关注其对肾功能长期的影响.

Impact of living donor nephrectomy on the early kidney function for donors

Objective To analyze the early renal function of donors after nephrectomy. Methods Clinical data of 467 cases of living kidney donors during the period from April, 2010 and November, 2014 in our center were retrospectively analyzed. Data on serum creatinine (Scr), glomerular filtration rate (GFR), serum uric acid (UA), and urine microproteins before operation and three days, seven days, one month and three months after operation were collected to evaluate the impact of nephrectomy on early renal function after operation for donators. Results Before operation and three days, seven days, one month, three months after operation, the average serum creatinine (Scr) level was (59.9±12.8), (85.8±21.0), (91.2±21.3), (92.8±21.6), (91.0±21.3) μmol/L, respectively; The GFR were (113.5±25.3), (75.1±17.9), (70.3±15.2), (68.5±16.0), (69.5±15.1) ml/min, respectively; The levels of uric acid were (292.60±79.58), (142.18±55.28), (228.41±66.39), (321.31±83.72), (346.61±87.21) μmol/L, respectively; All these data above-mentioned after operation reached statistical significance compared with that before operation (P＜0.05). Parameters including urine IgG, urine albumin, urine retinol-binding protein and urine β2-microglobulin post-operation time point were significantly different when compared with relative parameters pre-operation (P＜0.05). Conclusions Nephrectomy has significant influence on GFR, uric acid, and urine microprotein for donors in the early stage after operation. It's worth to evaluate nephrectomy's long-term effect on the renal function of donors in clinical practice.