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[摘要]：Background. The rate of change in estimated glomerular filtration rate (Delta eGFR), factors influencing Delta eGFR, and its association with mortality has not been well studied in renal transplant recipients.Methods. Adult kidney-only recipients between January 2001 and December 2004, with surviving grafts 1 year after transplantation, from England and Wales were followed up till 31 December 2006, graft failure or death. The four variable modification of diet in renal disease equation was used to estimate GFR and Delta eGFR assessed using linear least square regression. Delta eGFR of -1 mL/min/1.73 m(2) per year and above was considered to be stable or improving function. Linear regression and Cox regression analyses were used to examine factors influencing Delta eGFR and its association with mortality, respectively.Results. Of the 2,927 patients included, Delta eGFR was -1.3 +/- 6.0 mL/min/1.73 m(2) per year and eGFR remained stable or improved in the majority (54.8%). Baseline graft function at 1 year or live donor status did not influence Delta eGFR. Male donor to female recipient transplantation, younger recipients, diabetes, white race, and human leukocyte antigen mismatch were associated with faster decline in eGFR. Delta eGFR was not associated with mortality when censored for graft failure.Conclusions. Majority of renal transplant recipients experienced stable or improved graft function. Specific donor and recipient characteristics influenced the rate of decline in eGFR. The lack of association of Delta eGFR with mortality, the stability of eGFR in the majority, and influence of donor characteristics on Delta eGFR suggest caution when applying prognosis knowledge from the native kidney disease to the kidney transplant population. |
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