高龄供者血清Klotho水平预测受者术后移植肾功能状态的临床研究

王健富; 邓庚国; 朱春丽; 李琴; 周结学; 蒙善东; 申升; 王晓; 马娟; 刘东

doi:10.3969/j.issn.1674-7445.2019.04.015

高龄供者血清Klotho水平预测受者术后移植肾功能状态的临床研究

doi: 10.3969/j.issn.1674-7445.2019.04.015

510317 广州，广东省第二人民医院器官移植科

基金项目:

广东省科技计划项目 2014A020212680

广州市科技计划项目 201707010366

详细信息

作者简介:
王健富，男，1982年生，硕士，主治医师，研究方向为移植免疫耐受，Email：wjf7103@163.com

通讯作者:
刘东，男，1963年生，博士，主任医师，研究方向为器官缺血再灌注，Email：Ld177@163.com

中图分类号: R617
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出版历程
- 收稿日期: 2019-05-30
- 网络出版日期: 2021-01-19
- 刊出日期: 2019-07-15

Clinical study of value of serum Klotho level of elderly donors in predicting postoperative renal graft function in recipients

Department of Organ Transplantation, Guangdong Second Provincial People's Hospital, Guangzhou 510317, China

More Information

Corresponding author: Liu Dong, Email:Ld177@163.com

摘要

摘要: 目的探讨高龄供者血清Klotho水平预测受者移植肾功能的可行性。方法选取16例高龄供者和相应27例肾移植受者的临床资料。观察肾移植受者的一般情况。检测高龄供者器官获取手术当日血清Klotho和血清肌酐（Scr）水平。检测肾移植受者术后1、3、12个月的Scr水平，计算估算肾小球滤过率（eGFR），分析供者血清Klotho水平与受者术后移植肾功能的相关性。结果肾移植术中的冷缺血时间为（649±245）min，受者移植物功能延迟恢复（DGF）发生率为26%，急性排斥反应发生率为7%。高龄供者血清Klotho水平为537（245~793）pg/mL，Scr水平为（164±62）μmol/L。受者术后1、3、12个月的Scr水平分别为（136±47）、（132±43）、（133±46）μmol/L，相应的eGFR分别为（52±20）、（52±19）、（53±21）mL/（min·1.73 m²）。高龄供者血清Klotho水平与受者术后1个月移植肾功能呈负相关（P < 0.05）。血清Klotho水平预测术后1个月移植肾功能不全的灵敏度和特异度分别为0.909和0.769。结论高龄供者术前血清Klotho水平对受者术后1个月移植肾功能具有预测价值。
- 肾移植 /
- Klotho /
- 高龄供者 /
- 边缘供肾 /
- 移植肾功能 /
- 血清肌酐 /
- 受试者工作特征(ROC)曲线
Abstract: Objective To explore the feasibility of serum Klotho level in the elderly donors to predict the renal graft function in the recipients. Methods Clinical data of 16 elderly donors and 27 recipients undergoing renal transplantation were collected. The general status of the recipients was observed. The levels of serum Klotho and serum creatinine (Scr) in the elderly donors were measured on the day of renal transplantation. The Scr levels in the recipients were measured at postoperative 1, 3 and 12 months respectively. The estimated glomerular filtration rate (eGFR) was calculated. The correlation between the serum Klotho level of the donors and postoperative graft function of the recipients was analyzed. Results The cold ischemia time during renal transplantation was (649±245) min. The incidence rate of delayed graft function (DGF) was 26%. The incidence rate of acute rejection was 7%. In the elderly donors, the serum Klotho level was 537 (245-793) pg/mL and the Scr level was (164±62) μmol/L. At postoperative 1, 3 and 12 months, the Scr levels in the recipients were (136±47), (132±43) and (133±46) μmol/L, respectively. The corresponding eGFR was (52±20), (52±19) and (53±21) mL/(min?1.73m²), respectively. The serum Klotho level in the elderly donors was negatively correlated with the renal graft function at postoperative 1 month in the recipients (P < 0.05). The sensitivity and specificity of serum Klotho level in predicting the renal graft insufficiency at postoperative 1 month were 0.909 and 0.769. Conclusions The preoperative serum Klotho level in the elderly donors have predictive value for renal graft function in the recipients at postoperative 1 month.
- Renal transplantation /
- Klotho /
- Elderly donor /
- Marginal donor kidney /
- Renal graft function /
- Serum creatinine /
- Receiver operating characteristic (ROC) curve

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图 1 高龄供者Klotho水平对受者移植肾功能预测的ROC曲线分析

Figure 1. ROC curve analysis of Klotho level in elderly donors for predicting allograft renal function in recipients

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