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Predictive Capacity of Pre‐Donation GFR and Renal Reserve Capacity for Donor Renal Function After Living Kidney Donation
Author(s) -
Rook M.,
Hofker H. S.,
Van Son W. J.,
Homan van der Heide J. J.,
Ploeg R. J.,
Navis G. J.
Publication year - 2006
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2006.01359.x
Subject(s) - renal function , medicine , urology , donation , kidney donation , logistic regression , transplantation , kidney , kidney transplantation , body mass index , economics , economic growth
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 (GFR b ) and 57 ± 16 days after donation (GFR post ). Reserve capacity was assessed as GFR during stimulation by low‐dose dopamine (GFR dopa ), amino acids (GFR AA ) and both (GFR max ).GFR b was 112 ± 18, GFR dopa 124 ± 22, GFR AA 127 ± 19 and GFR max 138 ± 22 mL/min. After donation, GFR remained 64 ± 7%. GFR post was predicted by GFR b(R 2 = 0.54), GFR dopa(R 2 = 0.35), GFR AA(R 2 = 0.56), GFR max(R 2 = 0.55)and age (R 2 =–0.22; p < 0.001for all). Linear regression provided the equationGFR post = 20.01 + (0.46*GFR b ). Multivariate analysis predicted GFR post by GFR b , age and GFR max(R 2 = 0.61, p < 0.001). Post‐donation renal function impairment (GFR ≤ 60 mL/min/1.73 m 2 ) occurred in 31 donors. On logistic regression, GFR b , 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.