To analyze the prognosis of kidney recipients and transplanted kidneys after donor kidney transplantation with different Remuzzi scores.

The clinical data of 81 recipients of single kidney transplantation in Renmin Hospital of Wuhan University from November 2018 to August 2020 were retrospectively analyzed. The recipients were divided into low-scoring group (38 cases, Remuzzi score 0-3 points) and high-scoring group (43 cases, Remuzzi score 4-6 points). Measurement data with normal distribution were compared using two independent samples t test. Measurement data with nonnormal distribution were compared using the Mann-Whitney U test. The counting data were compared using the chi-squared test or fisher′s exact probability method. Graphpad 8.0.2 was used to plot the recipient/transplant kidney survival curve, and the log-rank test was used to compare the survival rate. P<0.05 for the difference was considered statistically significant.

The donor kidney Remuzzi score of 38 recipients in the low-scoring group was (2.23±0.87) and the donor kidney Remuzzi score of 43 recipients in the high-scoring group was (4.56±0.66), and the difference was statistically significant (t=-13.449, P<0.05). Serum levels of creatinine of the low-scoring group at 1, 3 months postoperatively were (143±92) and (136±75) μmol/L, respectively, while the high-scoring group were (138±80) and (123±39) μmol/L, respectively, and the differences were not statistically significant (t=0.237 and 1.031, all P>0.05). Serum levels of creatinine of the low-scoring group at 6 months after transplantation was 107.5 (60, 821) μmol/L, which was lower than the high-scoring group [113.0 (67, 224) μmol/L], the difference was statistically significant (U=-0.371, P<0.05). The estimated glomerular filtration rates were (60±24), (59±26) and (61±27) mL/min at the 1, 3, and 6 months after surgery in the low-scoring group, and the high-scoring group were (64±25), (64±21) and (66±20) mL/min, respectively, and the differences were not statistically significant (t=-0.823, -0.903 and -0.756, all P>0.05). The recipients were followed up for (29±6) months (1-36 months) by February 14, 2022. Delayed graft function (DGF) occurred in 16 recipients in the low-scoring group (42.1%), and DGF occurred in 12 recipients in the high-scoring group (27.9%), and the difference was not statistically significant (χ²=0.180, P>0.05). There was no significant difference in postoperative survival rate of recipients between the 2 groups (χ²=0.668, P>0.05). The difference in transplant kidney survival rate between the 2 groups was statistically significant (χ²=4.078, P<0.05). There were no significant differences in postoperative survival rates and transplanted kidney survival rates among recipients with DGF or without DGF in low-scoring and high-scoring groups (all P>0.05).

The Remuzzi score, as an important part of the assessment of donor renal pathology, provides some guidance for kidney recipients′ later treatment, and donor kidneys with higher scores can also receive a good prognosis for recipients.