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Chronologically different impacts of immunologic and non-immunologic risk factors on renal allograft function

Authors
 Myoung Soo Kim  ;  Dong Kee Kim  ;  Kiil Park  ;  Shin-Wook Kang  ;  Jong Hoon Lee  ;  Yu Seun Kim  ;  Chang-Kwon Oh  ;  Soon Il Kim  ;  Sung Min Myoung 
Citation
 CLINICAL TRANSPLANTATION, Vol.19(6) : 742-750, 2005 
Journal Title
 CLINICAL TRANSPLANTATION 
ISSN
 0902-0063 
Issue Date
2005
MeSH
Age Factors ; Analysis of Variance ; Creatinine/blood ; Female ; Graft Rejection/epidemiology ; Graft Survival ; Humans ; Kidney Function Tests ; Kidney Transplantation*/immunology ; Kidney Transplantation*/mortality ; Male ; Organ Size ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome
Keywords
age factors ; kidney transplantation ; nephron mass ; renal function ; risk factors
Abstract
INTRODUCTION: Upon analysis of the risk factors affecting renal graft survival and function, the time-dependent effects of each risk factor should be differentiated from their net effects. To evaluate the chronologically different impacts of risk factors on graft renal function, we reviewed 390 recipients who received a kidney from 1-haplotype-matched living-related donors. MATERIALS AND METHODS: Until 5-yr post-transplantation (TX), yearly serum creatinine (Scr), 24-h urinary excretion of protein, and their yearly changes were compared by the episodes of acute rejection within 1 yr, the kidney weight to recipient body weight (KW/BW) ratio, the donor/recipient (D/R) age ratio, and the D/R gender pairing. The Kaplan-Meier method, Cox proportional hazard model, ANOVA, and repeated measures ANOVA were each applied for different purposes. RESULTS: Only the episodes of acute rejection were a significant risk factor affecting graft survival. The episodes of acute rejection, KW/BW ratio, D/R age ratio, and D/R gender pairing consistently and independently had significant influences on Scr. Recipients having the lowest KW/BW ratio (first quartile) or the highest D/R age ratio (fourth quartile) had rapid increments of Scr after 4-yr post-TX. After 3-yr post-TX, there were significant correlations between the number of non-immunologic risk factors present and the yearly changes in Scr. CONCLUSIONS: Non-immunologic factors had a detrimental effect on renal graft function, especially after 3-yr post-TX. If immunologic risks seem to be similar, size matching, age, and gender pairing should be considered for better long-term graft function in renal TX recipients.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-0012.2005.00414.x/abstract
DOI
10.1111/j.1399-0012.2005.00414.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Dong Ki(김동기)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Myoung, Sung Min(명성민)
Park, Ki Il(박기일)
Oh, Chang Kwon(오창권)
Lee, Jong Hoon(이종훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/114750
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