Factors associated with renal function compensation after donor nephrectomy. / Factores asociados a la compensación de la función renal tras la nefrectomía para donación.
Nefrologia (Engl Ed)
; 38(5): 528-534, 2018.
Article
em En, Es
| MEDLINE
| ID: mdl-29773235
ABSTRACT
INTRODUCTION:
Kidney transplant donors lose 50% of their renal mass after nephrectomy. The remaining kidney compensates for this loss and it is estimated that 70% of the baseline renal function prior to donation is recovered. Factors associated with post-donation renal compensation are not well understood.METHODS:
Retrospective study of 66 consecutive kidney donors (mean age 48.8 years, 74.2% women). We analysed the potential factors associated with the compensatory mechanisms of the remaining kidney by comparing donors according to their renal compensation rate (RCR) (Group A, infra-compensation [<70%]; Group B, normal compensation [>70%]).RESULTS:
We compared Group A (n=38) and group B (n=28). Predictors for RCR>70% were higher baseline creatinine (A vs B 0.73±0.14 vs 0.82±0.11; P=.03) and a lower baseline glomerular filtration rate (GFR), estimated both by MDRD-4 (A vs B 97.7±18.8 vs 78.6±9.6ml/min; P<.001) and CKD-EPI (A vs B 101.7±15 vs. 88.3±11.7ml/min; P≤.001). Age, gender, smoking, hypertension and GFR measured by Tc-DTPA did not show any correlation with the RCR. The multivariate analysis confirmed baseline estimated glomerular filtration rate (eGFR) to be a predictor of compensation the higher the baseline eGFR, the lower the likelihood of >70% compensation (MDRD-4, OR=0.94 [95% CI 0.8-0.9], P=.01). The compensation rate decreased by 0.4% (P<.001) and 0.3% (P=.006) for every ml/min increase in baseline eGFR estimated by MDRD-4 and CKD-EPI, respectively.CONCLUSIONS:
One year after living donor nephrectomy, the remaining kidney partially compensates baseline renal function. In our experience, baseline eGFR is inversely proportional to the one-year renal compensation rate.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doadores Vivos
/
Recuperação de Função Fisiológica
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Rim
/
Nefrectomia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Ano de publicação:
2018
Tipo de documento:
Article