MP52-07 SHORT AND LONG TERM IMPACT OF TOBACCO SMOKING ON DONOR RENAL FUNCTION FOLLOWING LIVE KIDNEY DONATION

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II (MP52)1 Apr 2020MP52-07 SHORT AND LONG TERM IMPACT OF TOBACCO SMOKING ON DONOR RENAL FUNCTION FOLLOWING LIVE KIDNEY DONATION Christopher Kauffman-Ortega*, Adrian M. Garza-Gangemi, Mariano Oropeza-Aguilar, Bernardo Gabilondo-Pliego, and Francisco T. Rodriguez-Covarrubias Christopher Kauffman-Ortega*Christopher Kauffman-Ortega* More articles by this author , Adrian M. Garza-GangemiAdrian M. Garza-Gangemi More articles by this author , Mariano Oropeza-AguilarMariano Oropeza-Aguilar More articles by this author , Bernardo Gabilondo-PliegoBernardo Gabilondo-Pliego More articles by this author , and Francisco T. Rodriguez-CovarrubiasFrancisco T. Rodriguez-Covarrubias More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000914.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The negative impact of tobacco smoking in renal function has been widely studied. However, there is limited knowledge about the effect of smoking in preoperative and postoperative renal function in living kidney donors. The objective of this study is to evaluate the short and long term impact of smoking on donor renal function. METHODS: Retrospective observational study of prospectively collected data with 2 years follow up of 308 patients who underwent live kidney donation at a tertiary referral hospital in Mexico City. We compared baseline characteristics as well as functional outcomes following live kidney donation according to a past history of tobacco smoking. Estimated glomerular filtration rate (eGFR) was calculated with the Modification of Diet in Renal Disease (MDRD) equation in 6 time periods: preoperative, 1 week, 1 month, 6 months, 12 months and 24 months after surgery. We performed binary logistic regression analysis to identify risk factors associated with chronic kidney disease (CKD) at 24 months of follow up. ROC curve analysis was performed to identify a smoking index cut off point for CKD. Chronic Kidney Disease was defined as eGFR <60 ml/min/1.73m2. RESULTS: Median follow up was 24 months. Among donors, 106 (34.4%) reported a positive smoking history before nephrectomy and 202 (65.6%) had never smoked. Most of the smoking donor group were male (57.5% vs 33.7%, p= 0.00). Renal donors with smoking history had worse preoperative eGFR than non-smokers (90 ± 26.3 ml/min/1.73m2 vs 96 ± 27ml/min/1.73m2, respectively; p=0.02) and lower eGFR at 1 week (p=0.01), 1 month (p=0.00), 6 months (p=0.01) and 12 months (66 ± 25.3 ml/min/1.73m2 vs 74 ± 22ml/min/1.73m2, respectively; p=0.01) after the nephrectomy. At 24 months, no difference was found in the postoperative renal function between both groups. The smoking index cut off point for CKD with AUC 0.67 was 3.2. Smoking history (OR 3.35, p= 0.002) and age above 40 years old at donation (OR 6.59, p= 0.00) were associated with postoperative development of CKD in living renal donors at 24 months. CONCLUSIONS: Living kidney donors with tobacco smoking history require close follow up during the first postoperative year due to the increased risk of developing chronic kidney disease. Smoking cessation strategies should be implemented before and after the nephrectomy. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e774-e774 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Kauffman-Ortega* More articles by this author Adrian M. Garza-Gangemi More articles by this author Mariano Oropeza-Aguilar More articles by this author Bernardo Gabilondo-Pliego More articles by this author Francisco T. Rodriguez-Covarrubias More articles by this author Expand All Advertisement PDF downloadLoading ...