Abstract
Accurate assessment of kidney function by measurement of glomerular filtration rate (GFR) is essential to the risk assessment of prospective living kidney donors. We evaluated the performance of various estimating equations for creatinine clearance (Cockcroft-Gault), GFR (Modification of Diet in Renal Disease, Chronic Kidney Disease Epidemiology Collaboration), and 24-hour urine collections for creatinine clearance in obese potential kidney donors. We evaluated 164 potential kidney donors including 49 with a BMI of 30–35 and 32 with a BMI >35 that have completed a routine living donor evaluation with a measured GFR. All the estimating equations performed poorly in obese donors. While 24-hour urine collections performed better, only 15% had an adequate 24-hour urine collection. Since obese kidney donors may be at higher than average risk for kidney failure, accurate assessment of kidney function in these donors is crucial to ensure their long-term health postdonation.
Highlights
Kidney transplantation is considered the treatment of choice for selected patients with end-stage kidney disease
We evaluate the performance of estimating equations for creatinine clearance and glomerular filtration rate (GFR) and assess the accuracy of calculated creatinine clearance by 24-hour urine collection in GFR estimation in normal to morbidly obese potential kidney donors
Individuals 18 years and older, who were evaluated as possible live kidney donors from September 1, 2009 to December 31, 2010 at the University of Illinois at Chicago were included if they had a measured glomerular filtration rate completed as part of their workup
Summary
Kidney transplantation is considered the treatment of choice for selected patients with end-stage kidney disease. Successful transplantation provides a better quality of life and survival advantage to these patients [1]. When compared to deceased donor transplantation, living donor kidneys provide better long-term patient and graft survival rates, shorter wait times, as well as an opportunity for early or preemptive transplant [2]. Transplant surgery can be performed electively and the graft usually shows prompt function postoperatively. Prospective living donors undergo extensive medical and psychosocial evaluation to ensure that donation is safe for both recipient and donor. Most transplant programs have used a glomerular filtration rate (GFR) cut-off of 80 mL/min/1.73 m2 to define optimal live kidney donors [3]. Greater levels of predonation GFR are thought to leave the living donor with adequate kidney function post-donation. There is no consensus regarding the best method to determine GFR
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