Predictive capacity of pre-donation GFR and renal reserve capacity for donor renal function after living kidney donation.

Journal article

Kidney transplantation from living donors is important to reduce organ shortage. Reliable pre-operative estimation of post-donation renal function is essential. We evaluated the predictive potential of pre-donation glomerular filtration rate (GFR) (iothalamate) and renal reserve capacity for post-donation GFR in kidney donors. GFR was measured in 125 consecutive donors (age 49 +/- 11 years; 36% male) 119 +/- 99 days before baseline GFR (GFRb) and 57 +/- 16 days after donation (GFRpost). Reserve capacity was assessed as GFR during stimulation by low-dose dopamine (GFRdopa), amino acids (GFRAA) and both (GFRmax). GFRb was 112 +/- 18, GFRdopa 124 +/- 22, GFRAA 127 +/- 19 and GFRmax 138 +/- 22 mL/min. After donation, GFR remained 64 +/- 7%. GFRpost was predicted by GFRb(R2 = 0.54), GFRdopa(R2 = 0.35), GFRAA(R2 = 0.56), GFRmax(R2 = 0.55)and age (R2 = -0.22; p < 0.001 for all). Linear regression provided the equation GFRpost = 20.01 + (0.46*GFRb). Multivariate analysis predicted GFRpost by GFRb, age and GFRmax(R2 = 0.61, p < 0.001). Post-donation renal function impairment (GFR < or = 60 mL/min/1.73 m2) occurred in 31 donors. On logistic regression, GFRb, body mass index (BMI) and age were independent predictors for renal function impairment, without added value of reserve capacity. GFR allows a relatively reliable prediction of post-donation GFR, improving by taking age and stimulated GFR into account. Long-term studies are needed to further assess the prognostic value of pre-donation characteristics and to prospectively identify subjects with higher risk for renal function loss.

Authors: Rook, M; Hofker, H; van Son, W; Homan van der Heide, J; Ploeg, R

• Publication status: Published
• Journal: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
• Volume: 6
• Issue: 7
• Pages: 1653-1659
• Publication date: 2006-07-01
• DOI: 10.1111/j.1600-6143.2006.01359.x
• EISSN: 1600-6143
• ISSN: 1600-6135
• Language: English
• Keywords: Kidney Transplantation; Male; Donor Selection; Glomerular Filtration Rate; Follow-Up Studies; Humans; Female; Middle Aged; Nephrectomy; Living Donors; Kidney