Renal Function of Living Kidney Donors at Kenyatta National Hospital Nairobi-Kenya

Abstract

Background: The outcome of live kidney donation has been of concern since the recognition of hyperfiltration injury post live kidney donation. Studies on the topic have arrived at different conclusions regarding kidney function following live kidney donation; some suggest the possibility of renal progression while others report renal function similar to that of the general population. However, there are no studies done in a homogeneously African population to compare with. Beginning the year 2010 at Kenyatta National Hospital, Kenya, live kidney donation happened regularly with an average of two live related kidney donation and transplantation per month. The purpose of this study was to assess the impact of renal donation on renal function of live kidney donors at Kenyatta national hospital. Objective: To determine serum creatinine levels, eGFR, prevalence of proteinuria, and hypertension among living kidney donors at Kenyatta National Hospital. Study design: Cross-sectional descriptive study Methods: Using a questionnaire, a targeted history was obtained from kidney donors. A venous blood sample was drawn for serum creatinine measurement from which an eGFR was calculated using Cockroft-Gault equation. A sample of urine was collected from which proteinuria was determined using a standard urinary dip stick. Furthermore, blood pressure, height and weight were measured followed by the determination of the body mass index of the study subjects. Patient’s pre-nephrectomy records were reviewed and blood pressure, weight, height, serum creatinine levels were recorded. Their body mass index and estimated glomerular filtration rate pre-nephrectomy was then calculated. The prevalence of hypertension and proteinuria was expressed as proportions. Using a paired student’s t-test, mean changes for serum creatinine, estimated glomerular filtration rate, diastolic blood pressure and systolic blood pressure were determined. Statistical significance was pegged at P-value of <0.05. Results: A total of 52 subjects were enrolled in the study. The mean (± standard deviation) estimated glomerular filtration rate post-nephrectomy was 79.96mls/min/M² (± 31.95mls/min/M²) which transformed to 85.62% of the pre-nephrectomy estimated glomerular filtration rate. The prevalence of proteinuria, and hypertension was 21.2% and 9.6% respectively. New onset hypertension was 6%. 40% of the subjects were either overweight or obese. There was a significant mean change for serum creatinine, estimated glomerular filtration rate and diastolic blood pressure when pre-neprectomy and post-nephrectomy values were compared with p values of <0.0001, 0.002 and 0.008 respectively. Conclusion: At the mean duration of follow up of 15.9 months, the kidney donors studied regained their renal function with a tendency towards hyperfiltration. The prevalence of proteinuria and hypertension was low. The results of the study compared well with those obtained from other studies.