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首页> 外文期刊>Digestive Diseases and Sciences >Pre-transplant kidney function predicts chronic kidney disease after liver transplant: meta-analysis of observational studies.
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Pre-transplant kidney function predicts chronic kidney disease after liver transplant: meta-analysis of observational studies.

机译：移植前的肾功能可预测肝移植后的慢性肾脏疾病：观察性研究的荟萃分析。

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BACKGROUND: Chronic kidney disease is a common problem in long-term survivors after liver transplantation. Several studies to clarify the risk factors for incidence of chronic kidney disease among liver transplant recipients, including preoperative kidney function, have yielded conflicting results. AIM: The aim of this study was to conduct a systematic review of the published medical literature on the impact of pre-transplant kidney function on the occurrence of chronic kidney disease after liver transplantation. METHODS: Study-specific relative risks were weighted by the inverse of their variance to obtain fixed- and random-effects pooled estimates for incidence of chronic kidney disease across the published studies. The relative risk of chronic kidney disease after liver transplantation according to pre-transplant glomerular filtration rate was regarded as the most reliable outcome end-point. RESULTS: We identified seven studies (38,036 unique liver transplant recipients). A stratified analysis including only studies provided with glomerular filtration rate at transplant reported that the summary estimate of relative risk and 95% confidence intervals (CIs) for developing chronic renal failure among liver transplant recipients with diminished renal function at transplant was 2.12 (95% CI, 1.01; 4.46) (random-effects model). The p value for study heterogeneity was significant (p = 0.0001). Post-transplant chronic kidney disease shows impact on survival; the summary estimate for the adjusted relative risk of all-cause mortality with chronic kidney disease after liver transplant was 4.35 (95% confidence Intervals, 3.34; 5.66), p = 0.0001 (random-effects model). CONCLUSIONS: An increased risk of chronic kidney disease frequently exists among liver transplant recipients with reduced renal function at transplant. The occurrence of chronic kidney disease after liver transplantation has a major impact on mortality. Additional studies are needed to understand better the natural history of chronic kidney disease among liver transplant recipients.
机译：背景：慢性肾脏病是肝移植后长期幸存者的普遍问题。数项研究澄清了肝移植受者中慢性肾脏疾病发生的危险因素，包括术前肾功能，得出了相互矛盾的结果。目的：本研究的目的是对移植后的肾脏功能对肝移植后慢性肾脏疾病发生的影响进行医学文献综述。方法：研究特定的相对风险通过其方差的倒数加权，以获取已发表研究中慢性肾脏疾病发生率的固定和随机效应汇总估计值。根据移植前肾小球滤过率，肝移植后慢性肾脏疾病的相对风险被认为是最可靠的结局终点。结果：我们确定了七项研究（38,036名独特的肝移植受者）。一项仅包括移植时肾小球滤过率研究的分层分析报告显示，移植后肾功能减弱的肝移植接受者发生慢性肾功能衰竭的相对风险和95％置信区间（CI）的汇总估计为2.12（95％CI ，1.01; 4.46）（随机效应模型）。研究异质性的p值很显着（p = 0.0001）。移植后慢性肾脏疾病对生存率有影响;肝移植后慢性肾脏病全因死亡率调整后相对风险的汇总估计为4.35（95％置信区间，3.34; 5.66），p = 0.0001（随机效应模型）。结论：肝移植受者在移植时肾功能下降的情况下，慢性肾脏疾病的风险增加。肝移植后慢性肾脏疾病的发生对死亡率有重大影响。需要更多的研究来更好地了解肝移植接受者中慢性肾脏疾病的自然史。

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