#6910 PREDICTORS OF KIDNEY FUNCTION DECLINE IN LIVING KIDNEY TRANSPLANTATION DONORS

Abstract

Abstract Background and Aims After nephrectomy kidney transplant donors lose 50% of their renal mass. Shortage of donors and long waiting list for deceased donor transplantation expanded the living donor criteria. The aim of this study to identify pretransplant donor related factors associated with renal function decline. Method We retrospectively studied LDKT donors from one transplant center in the period 2013 -2022. Data was retrieved from medical history charts and national electronic database system. Demographic characteristics as age, gender and relation to the recipient, patients preference to donate the kidney with higher measured split GFR, the presence of diabetes, hypertension, hyperlipidemia and BMI >30kg/m2 were analysed. Estimated GFR by CKD EPI was notified prior donation, one and two years afterwards. In a multivariate regression analysis the reduction ratio of CKD EPI was explored as dependent variable. Results We studied 121 donors. The average age at time of transplant was 59.18 ± 10.99 years. Donors’ average eGFR was 91.53 ± 18.62 mL/min. Donor's age and eGFR were significantly correlated (p < 0.0001, r=r−0.529). Male donors were 37 (30%), 11 (9%) were unrelated to recipients, 9(7%) had BMI>30, 17 (14%) diabetes, 53 (44%) hypertension 5 (4% hyperlipidemia), and 65 (52%) had more then one comorbidity combined. Eight of donors (7%) decided to donate the better kidney. CKD EPI declined to 68.17±18.62 ml/min at first and 66.01±21.29 ml/min at the second year. The RR of 24.53 ± 20.60 % and 27.62±18.76% raised on yearly bases, respectively. In the univariate analysis of the GFR declination at the first year BMI>30 kg/m2 was associated with higher reduction of GFR (β=0.318, P = .003). At the second year the presence of diabetes emerged as worsening factor of GFR (β=0.227, P = .034) and BMI>30 kg/m2 kept its significance (β=0.426, P = .000). All the other parameters showed no significant associations to the GFR decline. In the multivariate analysis BMI>30 kg/m2 remained as most powerful predictor at 12 months reduction of eGFR. Conclusion Patients with diabetes and especially with obesity are at higher risk of rapid decline in kidney function after kidney donation. Careful assessment prior kidney donation should weight the risks.