A cross-sectional study of renal donors

Abstract

BACKGROUND: Living kidney donors donate half of their nephrons there are endowed with. The loss of one of their kidneys leads to hyperfiltration and compensatory changes in the remnant kidney. The degree of hyperfiltration, increase in protein excretion, increase in blood pressure, Hb status and development of metabolic complication is of interest. SUBJECTS AND METHODS: Thirty kidney donors were evaluated with BP recording, urinalysis, renal fuction tests, kidney size and glycemic status. Their eGFR was calculated by CG formula, aMDRD and CKD EPI creatinine equations. The GFR was measured by 99mTc-DTPA .All observations were compared with pre-donation data. The earliest period of evaluation was done 4 months post-donation and the latest patient was evaluated 13 years post donation. The median period of evaluation was 29 months. RESULTS: GFR measured by 99mTc-DTPA of the remnant kidney in all the donors was well within the normal range. And the degree of compensatory increase was more for younger donors. Peri-opertive complications occurred in 16.5%. Impaired fasting glucose was seen in 5 (16.5%), of which 4 of them were obese. Hypertension was seen in 6%. Though there increase in spot PCR post-donation, it was well within normal limits. eGFR calculated by CG formula, aMDRD and CKD EPI creatinine equations did not correlate with the GFR measured by 99mTc-DTPA, both pre and post donation. There was significant compensatory increase in kidney size. CONCLUSIONS: Renal compensation, in size and function leads to increase in GFR to normal levels. Impaired fasting glucose seen in 16.5% of our donors raises concern and stresses the need for stringent post-operative donor follow-up.