移植前不同透析方式及时间对肾移植远期效果的影响  

Impacts of different dialysis methods and time periods before transplantation on long-term effects of kidney transplantation

作　　者：杜鹏[1] 段斌[1] 张蓬杰[1] 陈瑞[1] 丁通[1] Du Peng;Duan Bin;Zhang Pengjie;Chen Rui;Ding Tong(Nephropathy Hemodialysis Center,Shaanxi Provincial People＇s Hospital,Xi＇an,Shaanxi,710068,China)

机构地区：[1]陕西省人民医院肾病血透中心,西安710068

出　　处：《西南国防医药》2018年第9期834-836,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨移植前不同透析方式及时间对肾移植远期效果的影响。方法回顾性分析2007年10月～2012年12月在医院诊治的肾移植手术患者300例,按照移植前透析方式不同分为血液透析(HD)组(205例)和腹膜透析(PD)组(95例),移植后随访5年,比较两组人/肾存活率、远期并发症发生率以及其与肾移植前透析时间的关系。结果两组肾移植受者人/肾存活率比较无显著差异,移植肾失功、感染、高血压、心血管疾病(CVD)等远期并发症的发生率无显著差异(P> 0.05)。两组移植前不同透析时间组的移植肾失功和感染的发生率均无显著性差异(P> 0.05);HD组移植前透析>1年者高血压和CVD的发生率显著高于移植前透析<1年的患者(P <0.05);PD组移植前不同透析时间组间高血压的发生率无显著差异(P> 0.05),>3年者CVD的发生率高于移植前透析时间<3年者(P <0.05)。结论肾移植受者在肾移植前无论接受HD还是PD,不影响肾移植效果及远期并发症,但透析时间越长,移植后发生高血压和CVD的概率越高,故进入终末期肾病患者应尽早进行肾移植手术。Objective To explore the impacts of different dialysis methods and time periods betore the transplantation on long-term effects of kidney transplantation. Methods A total of 300 patients who had received kidney transplant operation in our hospital from October 2007 to December 2012 were retrospectively analyzed. They were divided into a hemodialysis （HD） group （n=205） and a peritoneal dialysis （PD） group （n=95） according to the methods of pre-transplant dialysis. The two groups were tollowed up for five years after the transplantation. The patient/renal survival rate, the incidence of long-term complications and its correlation with the dialysis time periods betore the kidney transplantation were compared between the two groups. Results The patient/renal survival rate in the renal transplant recipients showed no significant difference, so did the incidence of such long-term complications as renal allograft dysfunction （RAD）, infection, hypertension and cardiovascular disease （CVD） （P 〉 0.05）. The incidence of tlAD and infection in the groups with different pre-transplant dialysis time periods showed no significant difference between the two groups（P 〉 0.05）; the incidence of hypertension and CVD in the patients with the pre-transplant dialysis time periods 〉 one year was significantly higher than that in the patients with the pre-transplant dialysis time periods〈one year （P 〈 0.05）; the incidence of hypertension between the groups with different pre-transplant dialysis time periods in the PD group showed no significant difference （P 〉 0.05）, the incidence of CVD in the patients with the pre-transplant dialysis time periods〉three years was higher than that in those with the dialysis time periods〈three years （P 〈 0.05）. Conclusion The receipt of HD or PD by renal transplant recipients betore the kidney transplantation does not aitect the eitects of kidney transplantation and long-term complications. However, the longer the dialysis time period is, the hi

关 键 词：血液透析 腹膜透析 肾移植 远期 并发症 透析时间 

分 类 号：R692[医药卫生—泌尿科学]