减重手术在肾移植领域的应用现状和展望  

The current status and prospect of bariatric surgery in the field of kidney transplantation

作　　者：陈政甫 王伦 王泽雨 张峥 胡力夫 肖明昊 姜涛[1] Chen Zhengfu;Wang Lun;Wang Zeyu;Zhang Zheng;Hu Lifu;Xiao Minghao;Jiang Tao(Department of Bariatric and Metabolic Surgery,China-Japan Union Hospital,Jilin University,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院减重与代谢外科,长春130033

出　　处：《中华泌尿外科杂志》2024年第10期805-808,共4页Chinese Journal of Urology

基　　金：吉林省卫生科研人才专项项目(2020SCZ04);吉林省科学与技术项目(20180101163JC)。

摘　　要：随着社会经济的发展和人们生活方式的改变,肥胖已成为一个非常突出的社会问题。肥胖及其导致的多种代谢性疾病如高血压病、糖尿病能够促进肾病的发生和发展,最终导致终末期肾病。肾移植是其最有效的治疗方法,但由于肥胖可使肾移植手术并发症和不良移植结局的风险明显增加,所以目前的观点认为肥胖患者在肾移植中获益有限,将肥胖列为肾移植的禁忌证。因此,肾移植前有效减重变得尤为重要,这不仅关系到移植候选者是否具备移植资格,还关系到后续的移植物存活率。减重手术相比传统减重方法能使肥胖患者快速达到合适的体重。近年来,越来越多的学者将减重手术应用到肾移植领域,研究结果表明减重手术能使肾移植候选者具备移植资格、增加移植物的存活率和延长患者生存期,甚至在移植前进行减重手术能改善终末期肾病患者的肾功能,从而使此类患者不再需要行肾移植手术。With the development of social economy and changes of lifestyle,obesity has become a very prominent social problem.Obesity and its-related metabolic diseases such as hypertension and diabetes can promote the occurrence and development of kidney disease,and eventually lead to end-stage renal disease..Kidney transplantation is the most effective treatment,but obesity increases the risk of surgical complications and poor outcomes.Hence obesity is considered a contraindication for kidney transplantation,as the benefits for obese patients are limited.Therefore,it becomes particularly important for obese patients to gain sufficient weight loss before kidney transplantation,which is not only related to whether transplant candidates are eligible for transplantation,but also the subsequent graft survival rate.Weight loss surgery can help obese patients achieve a significant amount of weight loss more quickly than traditional weight loss methods.In recent years,more and more scholars have applied bariatric surgery to the field of kidney transplantation.Research results have shown that bariatric surgery can improve the transplantation eligibility of kidney transplantation candidates with obesity,increase the survival rate of grafts and the lifetime of patients.Moreover,bariatric surgery can improve kidney function in patients with end-stage renal disease,thereby eliminating the need for kidney transplantation.At present,there is no any literature on the application of bariatric surgery in the field of kidney transplantation in China.This article reviews the current status and prospect of bariatric surgery in the field of kidney transplantation so as to provide reference for clinical practice.

关 键 词：减重手术 肾移植 月肥胖 肾病 

分 类 号：R699.2[医药卫生—泌尿科学]