背景:血管钙化是活体肾脏供体移植前成像中越来越常见的发现。我们打算探索是否可以找到Agatston钙化评分之间的联系,在捐献肾脏之前,和捐献后的肾功能。
方法:这是一项回顾性分析,对2010年1月至2016年12月期间接受活体肾切除术的156名活体肾供体进行了回顾性分析。我们通过计算每个血管的Agatston评分来量化总钙化评分(TCaScore),腹主动脉,髂总,和肾动脉.根据他们的TCaScore将捐献者分为两个不同的组:<100TCaScore组和≥100TCaScore组。TCaScore之间的关系,1年eGFR,蛋白尿,在5年的随访中,研究了1次肾功能下降(eGFR<60mL/min/1.73m2)的风险。
结果:≥100TCaScore组由29名(19%)捐献者组成,中位(四分位距)钙化评分为164(117-358)。这群人年龄明显较大,56.7±6.9vs.45.5±10.6(p<0.001),平均BMI较高(p<0.019),术前eGFR较低(p<0.014)。1年eGFR同样减少,69.9±15.7vs.76.3±15.5(p<0.048),虽然在随访期间肾功能下降的风险也增加,22%vs.48%(p<0.007)。
结论:我们的研究,通过单变量分析,发现TCaScore>100,较低的1年eGFR,5年内肾功能下降。然而,高于预期的血管钙化不应该是供体的排除因素,尽管在随访期间可能需要更密切的监测。
BACKGROUND: Vascular calcification is an ever-more-common finding in protocoled pre-transplant imaging in living kidney donors. We intended to explore whether a connection could be found between the Agatston calcification score, prior to kidney donation, and post-donation renal function.
METHODS: This is a retrospective analysis of 156 living kidney donors who underwent living donor nephrectomy between January 2010 and December 2016. We quantified the total calcification score (TCaScore) by calculating the Agatston score for each vessel, abdominal aorta, common iliac, and renal arteries. Donors were placed into two different groups based on their TCaScore: <100 TCaScore group and ≥100 TCaScore group. The relationship between TCaScore, 1-year eGFR, proteinuria, and risk of 1 measurement of decreased renal function (eGFR < 60 mL/min/1.73 m2) over 5 years of follow-up was investigated.
RESULTS: The ≥100 TCaScore group consisted of 29 (19%) donors, with a median (interquartile range) calcification score of 164 (117-358). This group was significantly older, 56.7 ± 6.9 vs. 45.5 ± 10.6 (p < 0.001), had a higher average BMI (p < 0.019), and had a lower preoperative eGFR (p < 0.014). The 1-year eGFR was similarly diminished, 69.9 ± 15.7 vs. 76.3 ± 15.5 (p < 0.048), while also having an increased risk of decreased renal function during the follow-up, 22% vs. 48% (p < 0.007).
CONCLUSIONS: Our study, through univariate analyses, found a relationship between a TCaScore > 100, lower 1-year eGFR, and decreased renal function in 5 years. However, a higher-than-expected vascular calcification should not be an excluding factor in donors, although they may require closer monitoring during follow-up.