Insufficient early renal recovery and progression to subsequent chronic kidney disease in living kidney donors

Yaerim Kim, Eunjeong Kang, Dong Wan Chae, Jung Pyo Lee, Sik Lee, Soo Wan Kim, Jang Hee Cho, Miyeun Han, Seungyeup Han, Yong Chul Kim, Dong Ki Kim, Kwon Wook Joo, Yon Su Kim, Hajeong Lee

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: Renal recovery of a kidney donor after undergoing nephrectomy though challenging is essential. We aimed to examine the effect of estimated glomerular filtration rate (eGFR) percent change at 1-month post-donation on insufficient kidney function after kidney donation. Methods: A total of 3,952 living kidney donors who underwent donor nephrectomy from 1982 to 2019 from eight differ-ent tertiary hospitals in Korea were initially screened. Percent changes in the eGFR from baseline to 1-month post-donation were calculated. The degree of percent changes was categorized by quartile, and the 1st quartile was regarded as the group with the lowest decreased eGFR at 1-month after donation. The remaining eGFR less than 60 mL/min/1.73 m2 was the end-point. The Cox proportional hazard model was used for evaluating the impact of initial eGFR and eGFR percent change at 1-month post-donation on the condition with remaining eGFR < 60 mL/min/1.73 m2. In the multivariate analysis, we used variables with a p < 0.1 in the univariate analysis. Results: A total of 1,585 donors were included in the analysis. During 62.2 ± 49.3 months, 13.7% of donors showed renal insufficiency. The 4th (adjusted hazard ratio [aHR], 10.41; 95% confidence interval [CI], 5.15 to 21.04) and the 3rd (aHR, 4.29; 95% CI, 2.15 to 8.56) quartiles of percent change in eGFR and the pre-donation eGFR (aHR, 0.90; 95% CI, 0.88 to 0.92) were associated with the development of renal insufficiency. Conclusions: The impact of worse initial renal recovery on renal insufficiency was pronounced in donors with lower pre-donation eGFRs. Additionally, worse initial renal recovery of remaining kidney affected the long-term development of renal insufficiency in kidney donors.

Original languageEnglish
Pages (from-to)1021-1030
Number of pages10
JournalKorean Journal of Internal Medicine
Volume37
Issue number5
DOIs
StatePublished - Sep 2022

Keywords

  • Early renal recovery
  • Kidne
  • Living donors
  • Renal insufficiency, chronic

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