The assessment of residual kidney function after living donor nephrectomy

Transplant Proc. 2009 Jan-Feb;41(1):91-2. doi: 10.1016/j.transproceed.2008.08.160.

Abstract

Background: The number of patients on the waiting list for kidney transplantation is increasing as a result of the cadaveric donor shortage. One way to expand the pool is living donor transplantation. However, only 2% of kidney transplants in Poland come from living-related donors.

Aim: We sought to assess residual renal function, incidence of hypertension, and proteinuria among living kidney donors.

Patients and methods: Between 2004 and 2007, we performed 46 living donor open nephrectomies. The mean age of the kidney donor was 39 years (range, 25-57). The donors were predominantly females (61%). Mean hospitalization time was 8 days (range, 4-22). Nine donors did not report for follow-up visits. The observation periods ranged from 1 to 24 months. Physical examination, blood and urine tests, as well as ultrasound scans were performed before nephrectomy and at every follow-up visit (1, 3, 12, and 24 months post operatively).

Results: Mean creatinine concentration was higher at 3 months after nephrectomy than preoperatively (P < .05). Mean creatinine clearance according to Cockroft-Gault formula and mean creatinine clearance according to abbreviated modification of diet in renal disease equation (aMDRD) decreased after donation by 30% (P < .05). No cases of proteinuria were observed. Hypertension occurred in 1 donor (2.7%).

Conclusion: Living kidney donation resulted in a reduced creatinine clearance in the donor. Follow-up of living kidney donors is essential to determine risk factors for deterioration of residual kidney function.

MeSH terms

  • Adult
  • Body Mass Index
  • Creatinine / blood
  • Family
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / epidemiology
  • Kidney Function Tests*
  • Length of Stay
  • Living Donors*
  • Male
  • Middle Aged
  • Nephrectomy / methods*
  • Poland
  • Postoperative Complications / epidemiology
  • Proteinuria / epidemiology
  • Siblings
  • Tissue Donors / supply & distribution
  • Tissue and Organ Harvesting / methods*

Substances

  • Creatinine