تحلیل بقای 8 ساله‌ی پیوند کلیه و تعیین عوامل مؤثر بر آن در بیماران پیوند شده در بیمارستان نور اصفهان

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استادیار، گروه آمار و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران

2 استاد، مرکز تحقیقات بیماری‌های کلیوی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استادیار، مرکز تحقیقات بیماری‌های کلیوی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 استادیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران

5 دانشجوی کارشناسی ارشد، گروه آمار و اپیدمیولوژی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهید صدوقی، یزد، ایران

چکیده

مقدمه: پیوند کلیه، درمان انتخابی بیشتر بیماران مبتلا به بیماری پیشرفته کلیه می‌باشد. بنابراین، تحلیل بقای پیوند کلیه دارای اهمیت است. هدف از انجام این مطالعه، تعیین میزان بقای تجمعی کلیه‌ی پیوندی و تعیین عوامل مؤثر بر آن بود.روش‌ها: این مطالعه به صورت هم‌گروهی تاریخی و شامل اطلاعات 381 بیمار مبتلا به End stage renal disease (ESRD) بود که از آذر 1386 تا پایان اسفند 1394 در بیمارستان نور اصفهان تحت جراحی پیوند کلیه قرار گرفتند. برای انجام محاسبات آماری، از روش Kaplan-Meier، آزمون Log rank و مدل رگرسیونی Cox استفاده شد. تحلیل داده‌ها با استفاده از نرم‌افزار R نسخه‌ی 0-1-3 انجام و 050/0 > P به عنوان سطح معنی‌داری در نظر گرفته شد.یافته‌ها: با استفاده از روش Kaplan–Meier میزان بقای 1، 3، 5 و 8 ساله‌ی کلیه‌ی پیوندی به ترتیب 7/98، 3/93، 9/86 و 9/83 درصد برآورد گردید. نتایج حاصل از مدل رگرسیونی Cox نشان داد که مدت زمان دیالیز قبل از پیوند (050/0 ≥ P) و مقدار کراتینین زمان ترخیص (050/0 ≥ P) با بقای پیوند کلیه ارتباط معنی‌داری داشت.نتیجه‌گیری: میزان بقای پیوند محاسبه شده برای این مرکز در مقایسه با سایر مراکز پیوند مقدار رضایت‌بخشی داشت و کراتینین زمان ترخیص و مدت زمان دیالیز قبل از پیوند، از عوامل تأثیرگذار بر بقای پیوند بودند.

کلیدواژه‌ها

عنوان مقاله [English]

8-Year Survival Analysis of Kidney Transplantation and Determining the Factors Affecting it in Kidney-Transplanted Patients in Noor Hospital in Isfahan, Iran

نویسندگان [English]

  • Mohsen Askarishahi 1
  • Shahrzad Shahidi 2
  • Abdolamir Atapoor 3
  • Roya Hemayati 4
  • Sajedeh Zeynali 5
1 Assistant Professor, Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2 Professor, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
4 Assistant Professor, Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
5 MSc Student, Department of Biostatistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
چکیده [English]

Background: Kidney transplantation is the preferred treatment for most patients with end-stage renal disease (ESRD) and therefore, kidney transplantation survival analysis is important. The aim of this study was to determine the cumulative survival rate of renal transplantation and the factors affecting it.Methods: This was a historic cohort study including information of 381 patients with end-stage renal disease who underwent kidney transplantation surgery from December 2007 to March 2016 in Noor hospital, Isfahan, Iran. The Kaplan-Meier method, Log Rank test and Cox regression model were used for statistical analysis. Data analysis was carried out with R software, Version 3.1.0, at the significance level of P < 0.05.Findings: According to Kaplan-Mayer method, 1-, 3-, 5- and 8-year survival rates of transplanted kidney were estimated as 98.7, 93.3, 86.9, and 83.9 percent, respectively. The results of Cox regression model indicated that the time duration of dialysis before transplantation (P < 0.05), and the level of creatinine at the time of discharge from hospital (P < 0.05) had significant relationship with survival of transplanted kidney.Conclusion: The survival rate of the transplanted kidney calculated for this center was suitable in comparison with other transplant centers. The level of creatinine at the time of discharge from hospital and the time duration of dialysis prior to transplantation were the factors influencing survival of the graft.

کلیدواژه‌ها [English]

  • Kidney transplantation
  • Transplantation
  • Survival
  • End-stage renal disease
  • Regression Analysis

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مجله دانشکده پزشکی اصفهان
دوره 35، شماره 442 - شماره پیاپی 442
مهر و آبان 1396
صفحه 1022-1029

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سابقه مقاله

  • تاریخ دریافت: 07 مرداد 1396
  • تاریخ بازنگری: 06 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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