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Assessment of renal function in living kidney donors before and after nephrectomy: A Japanese prospective, observational cohort study.
- Source :
-
International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2019 Apr; Vol. 26 (4), pp. 499-505. Date of Electronic Publication: 2019 Feb 28. - Publication Year :
- 2019
-
Abstract
- Objective: To investigate the utility of estimated glomerular filtration rate for assessing kidney function in living kidney donors before and after nephrectomy.<br />Methods: A total of 101 donors underwent inulin clearance measurements before and 1 year after nephrectomy. The mean of three inulin clearance values was used as the measured glomerular filtration rate. Estimated glomerular filtration rate based on serum creatinine and cystatin C levels was calculated using the Japanese estimated glomerular filtration rate equation, Chronic Kidney Disease Epidemiology Collaboration formula and new full age spectrum equation. Age-adjusted chronic kidney disease was defined as glomerular filtration rate <75 mL/min/1.73m <superscript>2</superscript> for donors aged <40 years, <60 mL/min/1.73m <superscript>2</superscript> for donors aged 40-65 years and <45 mL/min/1.73m <superscript>2</superscript> for donors aged >65 years.<br />Results: The postoperative measured glomerular filtration rate <60 mL/min/1.73m <superscript>2</superscript> and age-adjusted chronic kidney disease rate were 36.0% and 27.0%, respectively. In younger donors (aged <50 years), postoperative measured glomerular filtration rate <60 mL/min/1.73m <superscript>2</superscript> and age-adjusted chronic kidney disease rates were 5.3% and 26.3%, respectively. In older donors (aged >70 years), postoperative measured glomerular filtration rate <60 mL/min/1.73m <superscript>2</superscript> and age-adjusted chronic kidney disease rates were 75.0% and 33.3%, respectively. Donor age and measured glomerular filtration rate were significant predictors of postoperative measured glomerular filtration rate. The Japanese estimated glomerular filtration rate equation based on creatinine and cystatin C showed the strongest correlation with measured glomerular filtration rate. However, the Japanese estimated glomerular filtration rate equation based on creatinine overestimated the prevalence of measured glomerular filtration rate <60 mL/min/1.73m <superscript>2</superscript> , whereas the Japanese estimated glomerular filtration rate based on cystatin C underestimated it.<br />Conclusions: Aged donors might have an increased risk of lower glomerular filtration rate after donor nephrectomy; post-surgery, long-term monitoring of renal function is recommended. Measurement of glomerular filtration rate should be carried out for donors, especially pre-surgery. A more precise glomerular filtration rate equation is required in the future.<br /> (© 2019 The Japanese Urological Association.)
- Subjects :
- Adult
Age Factors
Aged
Creatinine blood
Creatinine metabolism
Cystatin C blood
Cystatin C metabolism
Donor Selection standards
Feasibility Studies
Female
Glomerular Filtration Rate physiology
Humans
Inulin administration & dosage
Inulin metabolism
Japan
Kidney surgery
Kidney Function Tests standards
Living Donors
Male
Middle Aged
Postoperative Period
Preoperative Period
Prospective Studies
Reference Values
Renal Elimination physiology
Renal Insufficiency, Chronic physiopathology
Donor Selection methods
Kidney physiology
Kidney Function Tests methods
Kidney Transplantation
Nephrectomy adverse effects
Renal Insufficiency, Chronic diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1442-2042
- Volume :
- 26
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- International journal of urology : official journal of the Japanese Urological Association
- Publication Type :
- Academic Journal
- Accession number :
- 30818421
- Full Text :
- https://doi.org/10.1111/iju.13923