이식신의 이식전후 사구체여과율의 변화에 관한 연구 = The Changes of Glomerular Filtration Rate in Allograft Kidney before and after Transplantation

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

Objectives : The GFR of transplanted kidney has been studied in human, which has been reported to be around 50% to 70% of the donor total GFR before nephrectomy. The magnitude of hyperfiltration in the transplanted kidney is 0% to 40% on the assumption that each donor kidney functions 50% of the total GFR. These studies, however, did not take the relative function of the donated kidney into consideration. This study was performed to evaluate the magnitude of hyperfiltration in the transplanted kidney by measuring the GFR of the donated kidney before nephrectomy, and to determine factors that affect the GFR of the transplanted kidney. Methods The author measured GFR using 51Cr-EDTA clearance (CEDTA) and creatinine clearance (Ccr) in 70 donors of llving related renal transplantation performed in Asan Medical Center from December 1992 to January 1994. With relative kidney function measured by DMSA scan, the auther calculated the GFR of the donated kidney before nephrectomy(D'CEDTA and D'Ccr, respectively). When renal function was stable, usually 3 months after transplantation, the author repeated CEDTA and Ccr(R'CEDTA and R'Ccr, respectively) in 61 recipients. Nine patients were excluded because they did not maintain stable renal function within 2 months of transplantation. Results: The relative renal function of the donated kidney ranged 33 to 56% (mean 49%) The GFR of donated kidney before nephrectomy (D'CEDTA and DCcr) ranged 39 to 85m1/min(mean 59) and 26 to 80ml/min(mean 49), respectively. As expected, there was a close correlation between R'CEDTA and D'CEDTA with RCEDTA=0.72×D'CEDTA+26ml/min (r=0.59, p<0.01) and the geometric mean of R'CEDTA/DCEDTA was 115% (n=47). There was a significant correlation between R'Ccr and O'Ccr with R'Ccr=0.43×D'Ccr+48mVmin (r=0.44, p<0,01) and the mean of R'Ccr/D'Ccr was 140Fo(n=43). D'CEDTA (p<0.01) and the donor age(p=0.02) related independently with R'CEDTA on multiple regression analysis(n=47). Conclusion: With these results, we conclude that: 1) The relative function of the donated kidney was distributed in a wide range. 2) Transplanted kidney functions at 15 to 40N above the prenephrectomy level in about 3 months after transplantation. 3) The GFR of the donated kidney before nephrectomy and the donor age affect the GFR of the transplanted kidney.