Matthew H Abramson, Insara Jaffer Sathick, Andrea Knezevic, Miguel-Angel Perales, Edgar A Jaimes
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引用次数: 0
摘要
背景:急性肾损伤(AKI)是异基因造血细胞移植(allo-HCT)的常见并发症,会增加死亡风险。与此相反,中性粒细胞移植时肠道微生物群的多样性越高,死亡率越低。我们的目的是更好地了解肾脏结果与这一患者群体肠道多样性变化的关系,假设基线和移植时微生物群多样性较低的患者发生肾脏并发症的风险较高:我们对本机构 2014-2017 年的 419 名造血细胞移植受者进行了单中心回顾性研究,并对其肠道微生物群进行了分析。我们根据 KDIGO 标准定义了 AKI 和 CKD,并使用 CKD 流行病学协作方程估算了肾小球滤过率(GFR)。我们使用香农和辛普森倒数多样性指数来定义肠道微生物组的多样性,指数越高表示微生物组越多样化:基线时,我们队列中的辛普森倒数DI和香农DI分别为21.8(IQR:13.7,35.2;范围:1.6,102.5)和3.7(IQR:3.2,4.2;范围:0.7,5.2),围移植期分别为6.3(IQR:3.7,10.4)和2.3(IQR:1.7,2.8)。在这419名患者中,263名(63%)患者在移植后100天内出现任何程度的AKI,114名(27%)患者出现2级以上AKI。与未出现肾脏并发症的患者相比,移植后出现AKI或CKD的患者在基线或移植前后的微生物组多样性没有明显差异:我们的研究结果不支持基线或移植周肠道多样性与接受异体器官移植的患者发生 AKI 或 CKD 的风险之间存在联系。这项研究强调了异体肾移植受者发生 AKI 的病因复杂且多因素,因此需要进行更多的前瞻性机理研究。