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JASN:活体肾脏捐献者肾脏捐赠之后ESRD风险量化!

2017-04-29 xing.T MedSci原创

由此可见,适当的知情同意对风险估计是至关重要的,并且不同的活体肾脏捐赠者风险估计有所不同。对年龄较大的黑人候选捐赠者给予更大的宽容可能是必要的;但对年轻的黑人候选者应予以仔细评估。

有研究已经估计了美国活体肾脏捐献者在捐献肾脏之后发生终末期肾脏病(ESRD)的平均风险,但基于捐献者的特征进行的个性化估计仍然没有文献报道。

近日,肾脏病领域权威杂志Journal of the American Society of Nephrology上发表一篇研究文章,研究人员使用Cox回归分析了从1987年到2015年期间在器官采购和移植网络中的133824名活体肾捐赠者,研究人员通过医疗保险和医疗补助服务联动中心来确定ESRD患者。

研究人员发现黑人种族(风险比[HR]为2.96;95%可信区间[95%CI]为2.25-3.89;P<0.001)和男性(HR为1.88;95%CI为1.50-2.35;P<0.001)与捐赠者发生ESRD的高风险相关。在非黑人捐献者中,年龄较大与较高的ESRD风险相关(每增加10岁的HR为1.40;95%CI为1.23-1.59;P<0.001)。在黑人捐献者中,年龄较大与较高的ESRD风险无关(HR为0.88;95%CI为0.72-1.09;P=0.3)。较大的体重指数与较高的ESRD风险相关(体重指数每增加5公斤/平方米其HR为1.61;95%CI为1.29-2.0;P<0.001)。捐献者与接受者存在一级生物学关系发生ESRD的风险增加(HR为1.70;95%CI为1.24-2.34;P<0.01)。模型的C统计量为0.71,预测捐献者发生ESRD的20年风险为中位数为每10000名捐献者只有34例发生ESRD,但有1%的捐献者预测风险超过每10000名捐助者有256例ESRD。

由此可见,适当的知情同意对风险估计是至关重要的,并且不同的活体肾脏捐赠者风险估计有所不同。对年龄较大的黑人候选捐赠者给予更大的宽容可能是必要的;但对年轻的黑人候选者应予以仔细评估。

原始出处:

Allan B. Massie,et al. Quantifying Postdonation Risk of ESRD in Living Kidney Donors. JASN, 2017,http://jasn.asnjournals.org/content/early/2017/04/26/ASN.2016101084.abstract

本文系梅斯医学(MedSci)原创编译整理,转载需授权!


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    2018-03-27 chenhongpeng
  4. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Sun Apr 30 09:59:03 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192075, encodeId=aea51920e567, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sun Apr 30 08:12:21 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192038, encodeId=f04c1920383f, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 30 00:59:21 CST 2017, time=2017-04-30, status=1, ipAttribution=)]
    2017-05-01 yige2004
  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 30 00:59:21 CST 2017, time=2017-04-30, status=1, ipAttribution=)]
    2017-05-01 林3301

    很多还是和种族,性别等等有关

    0

  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 30 00:59:21 CST 2017, time=2017-04-30, status=1, ipAttribution=)]
    2017-04-30 laymankey

    感谢分享一下!!

    0

  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Sun Apr 30 07:17:34 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192005, encodeId=2af319200563, content=学习了,不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 30 06:11:41 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191980, encodeId=067a191980ed, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 30 00:59:21 CST 2017, time=2017-04-30, status=1, ipAttribution=)]
    2017-04-30 刘煜

    谢谢分享

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1758641, encodeId=692e1e5864113, content=<a href='/topic/show?id=0fc55652546' target=_blank style='color:#2F92EE;'>#捐献#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, 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=Wed Aug 23 18:39:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756936, encodeId=2f661e5693644, content=<a href='/topic/show?id=db7856538ee' target=_blank style='color:#2F92EE;'>#捐赠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56538, encryptionId=db7856538ee, topicName=捐赠)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicList=[TopicDto(id=7041, encryptionId=6739e04128, topicName=ESRD)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66962500501, createdName=yige2004, createdTime=Mon May 01 11:39:00 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192384, encodeId=49c3192384c1, content=很多还是和种族,性别等等有关, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuBA90ng5ibXMmibn1feGOQ2cjw0S48DKsF0icicFlmRxwHibIic2TNGd22vVqkKRMj2cRSWbpqZAPBPgdt/0, createdBy=81031668757, createdName=林3301, createdTime=Mon May 01 07:12:11 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192112, encodeId=46fd1921128c, content=感谢分享一下!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Sun Apr 30 09:59:03 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192075, encodeId=aea51920e567, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sun Apr 30 08:12:21 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192038, encodeId=f04c1920383f, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Sun Apr 30 07:17:34 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192005, encodeId=2af319200563, content=学习了,不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 30 06:11:41 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191980, encodeId=067a191980ed, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 30 00:59:21 CST 2017, time=2017-04-30, status=1, ipAttribution=)]
    2017-04-30 医艺依意

    学习了,谢谢分享

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1758641, encodeId=692e1e5864113, content=<a href='/topic/show?id=0fc55652546' target=_blank style='color:#2F92EE;'>#捐献#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, 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=Wed Aug 23 18:39:00 CST 2017, time=2017-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756936, encodeId=2f661e5693644, content=<a href='/topic/show?id=db7856538ee' target=_blank style='color:#2F92EE;'>#捐赠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56538, encryptionId=db7856538ee, topicName=捐赠)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Sun Apr 30 09:59:03 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192075, encodeId=aea51920e567, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sun Apr 30 08:12:21 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192038, encodeId=f04c1920383f, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Sun Apr 30 07:17:34 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192005, encodeId=2af319200563, content=学习了,不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 30 06:11:41 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191980, encodeId=067a191980ed, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 30 00:59:21 CST 2017, time=2017-04-30, status=1, ipAttribution=)]
    2017-04-30 daiyaozu

    学习了,不错

    0

  10. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Sun Apr 30 09:59:03 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192075, encodeId=aea51920e567, content=谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sun Apr 30 08:12:21 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192038, encodeId=f04c1920383f, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/udqvoAsWtvRVficPKOpMh4M31O9bJ8jMiaUHAheeNpIqMapC8mUnBWfEskrcVjofbicWU4icRD6vFvVeEYlPmSbXELickazEGVFYO/0, createdBy=24741603767, createdName=医艺依意, createdTime=Sun Apr 30 07:17:34 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=192005, encodeId=2af319200563, content=学习了,不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/icyLhIGqru6gIknBJqfuPhQkEvDREF6S2vZq3ZIpUYjdqicKVoAWaJSGoe8xNvS6o6QpmOlh2AQ7xuUpj8NiaDjJJgjbc7Xj3T6/0, createdBy=1c242047915, createdName=daiyaozu, createdTime=Sun Apr 30 06:11:41 CST 2017, time=2017-04-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=191980, encodeId=067a191980ed, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Apr 30 00:59:21 CST 2017, time=2017-04-30, status=1, ipAttribution=)]
    2017-04-30 半夏微凉

    学习了谢谢分享

    0

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