Abstract:

Objective To explore the impact of fluid therapy on early renal function in polyuria stage afterkidney transplantation （KT）. Methods The retrospective study of clinical data from 115 living donor kidney transplant recipients at Tianjin First Central Hospital was conducted. Patients were grouped according to eGFR at 6-month after KT ：a good renal function group （eGFR≥ 60） and a poor renal function group （eGFR＜ 60）. The general data， intake and output volume， blood pressure， and other indicators were compared， and multifactorial logistic regression was used to predict the risk factors for poor recovery of transplanted kidney function. The correlation between the change of renal function and daily urine volume was analyzed. Results After adjusting for age， BMI and the use of vasoactive drugs during surgery， patients with higher fluid balance on total fluid balance within postoperative 3 d （OR＝1.321，95% CI＝1.005～1.736，P＝0.046） had a higher risk of poor renal function at 6-month. In addition， the decrease rates of serum creatinine （Scr）（r ＝ 0.518，r ＝ 0.267） and blood urea nitrogen （BUN）（r ＝ 0.555，r ＝ 0.322） at postoperative day 1 and day 2 were positivelycorrelated with the urine volume of the previous day （all P ＜ 0.05）. Conclusion In stage of polyuria after KT，appropriate negative fluid balance is beneficial to the recovery of early renal function in recipients with stable blood pressure. 

Key words:

 , Kidney transplantation； , Stage of polyuria； , Fluid therapy

摘要：

目的 探讨肾移植术后多尿期液体治疗对早期肾功能的影响。方法 回顾性分析天津市第一中心医院 115 例亲体肾移植受者临床资料。根据肾移植术后 6 个月 eGFR 分为肾功能良好组（eGFR ≥ 60）和肾功能不良组（eGFR ＜ 60）。比较两组患者一般资料、出入量、血压等指标，采用多因素 Logistic 回归预测移植肾功能恢复不良的危险因素，并对术后肾功能指标变化率与每日尿量进行相关性分析。结果 调整年龄、BMI 和术中使用血管活性药后，肾移植术后 3 d 总液体平衡量（OR ＝ 1.321，95%CI ＝ 1.005 ～ 1.736，P ＝ 0.046）较高的患者术后 6 个月肾功能不良风险高。此外，术后第 1、2 天血肌酐（r ＝ 0.518，r ＝ 0.267）、尿素氮（r ＝ 0.555，r ＝ 0.322）下降率均与前 1 d 尿量成正相关（均 P ＜ 0.05）。结论 肾移植术后多尿期在保证血压平稳的前提下，适当液体负平衡有利于受者早期肾功能恢复。

关键词: 肾移植 , 多尿期 , 液体治疗