Remaining kidney volume indexed to weight as a strong predictor of estimated glomerular filtration rate at 1 year and mid-term renal function after living-donor nephrectomy - a retrospective observational study.

Abstract

The donors' estimated glomerular filtration rate (eGFR) after living nephrectomy has been a concern, particularly in donors with smaller kindeys. Therefore, we developed this retrospective observational study in 195 donors to determine the ability remaining kidney volume indexed to weight (RKV/W) to predict eGFR at 1year through multivariate linear regression and to explore this relationship between annual eGFR change from 1 to 4years postdonation evaluated by a linear mixed model. Comparing RKV/W tertiles (T1, T2, T3), RKV/W was a good predictor of 1-year eGFR which was significantly better in T3 donors. Gender, predonation eGFR, and RKV/W were independent predictors of eGFR at 1-year. In a subgroup with predonation eGFR<90mL/min/1.73 m2 , a significant prediction of eGFR<60mL/min/1.73 m2 was detected in males with RKV/W≤2.51cm3 /kg. Annual eGFR (ml/min/year) change from 1 to 4years was+0.77. RKV/W divided by tertiles (T1-T3) was the only significant predictor: T2 and T3 donors had an annual eGFR improvement opposing to T1. RKV/W was a good predictor of eGFR at 1year, independently from predonation eGFR. A higher RKV/W was associated with improved eGFR at 1year. A decline in eGFR on the four years after surgery was only noticeable in donors with RKV/W≤2.13cm3 /kg.