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Association of mGFR of the Remaining Kidney Divided by Its Volume before Donation with Functional Gain in mGFR among Living Kidney Donors
- Source :
- Clinical Journal of the American Society of Nephrology. 11:1369-1376
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Background and objectives The predictors of long–term renal function in living kidney donors are currently discussed. Our objectives were to describe the predictors of functional gain of the remaining kidney after kidney donation. We hypothesized that GFR of the remaining kidney divided by volume of this kidney (rk-GFR/vol) would reflect the density of functional nephrons and be inversely associated with functional gain of the remaining kidney. Design, setting, participants, & measurements We conducted a prospective monocentric study including 63 living donors (26 men; 50.3±11.8 years old) who had been evaluated for 51Cr-EDTA and measured GFR, split renal function by scintigraphy before donation (between 2004 and 2009), and measured GFR at 5.7±0.5 years after donation. For 52 donors, volume of the remaining kidney (measured and estimated with the ellipsoid formula using renal computed tomography scannography) was determined before donation. We tested our hypothesis in an external validation cohort of 39 living donors (13 men; 51.0±9.4 years old) from another single center during the same time period. Results For the main cohort, the mean measured GFR was 97.6±13.0 ml/min per 1.73 m2 before donation and 63.8±9.4 ml/min per 1.73 m2 at 5 years. Functional gain averaged 16.2±7.2 ml/min per 1.73 m2 (+35.3%±16.7%). Multivariate analysis showed that age, body mass index, and rk-GFR/vol at donation were negatively correlated with functional gain and had strong predictive power of the 5-year functional gain (adjusted 5-year functional gain for age: −0.4 [95% confidence interval (95% CI), −0.5 to −0.1]; body mass index: −0.3 [95% CI, −0.6 to −0.1]; rk-GFR/vol: −55.1 [95% CI, −92.3 to −17.9]). We tested this model in the external validation cohort (adjusted 5-year functional gain for age: −0.1 [95% CI, −0.5 to 0.3]; body mass index: −0.9 [95% CI, −1.8 to −0.1]; rk-GFR/vol: −97.6 [95% CI, −137.5 to −57.6]) and confirmed that rk-GFR/vol was inversely associated with 5-year functional gain. Conclusions For given age and body mass index, the long–term functional gain of the remaining kidney is inversely associated with the new variable rk-GFR/vol at donation.
- Subjects :
- Adult
Male
medicine.medical_specialty
Tissue and Organ Procurement
Epidemiology
030232 urology & nephrology
Urology
Renal function
Kidney Volume
030230 surgery
Kidney
Critical Care and Intensive Care Medicine
Body Mass Index
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Living Donors
Humans
Medicine
Prospective Studies
Aged
Transplantation
business.industry
Age Factors
Original Articles
Nephrons
Organ Size
Middle Aged
Confidence interval
medicine.anatomical_structure
Blood pressure
Nephrology
Cohort
Albuminuria
Female
medicine.symptom
Tomography, X-Ray Computed
business
Body mass index
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 1555905X and 15559041
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Clinical Journal of the American Society of Nephrology
- Accession number :
- edsair.doi.dedup.....40b9a90c266397228af975a842466ff1