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Predictive factors of glomerular filtration rate loss associated with living kidney donation: a single-center retrospective study.
Orieux, Arthur; Bouchet, Antonin; Doreille, Alice; Paslaru, Liliana; Livrozet, Marine; Haymann, Jean-Philippe; Ouali, Nacera; Mesnard, Laurent; Letavernier, Emmanuel; Galichon, Pierre.
Afiliação
  • Orieux A; Sorbonne Universite, UMR_S 1155, INSERM, Tenon Hospital, Paris, France.
  • Bouchet A; Department of Nephrology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne Universite, Paris, France.
  • Doreille A; Claude Bernard University Lyon I, Lyon, France.
  • Paslaru L; Department of Nephrology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne Universite, Paris, France.
  • Livrozet M; Department of Radiology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne Universite, Paris, France.
  • Haymann JP; Sorbonne Universite, UMR_S 1155, INSERM, Tenon Hospital, Paris, France.
  • Ouali N; Department of Physiology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne Universite, Paris, France.
  • Mesnard L; Sorbonne Universite, UMR_S 1155, INSERM, Tenon Hospital, Paris, France.
  • Letavernier E; Department of Physiology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne Universite, Paris, France.
  • Galichon P; Department of Nephrology, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Sorbonne Universite, Paris, France.
World J Urol ; 40(9): 2161-2168, 2022 Sep.
Article em En | MEDLINE | ID: mdl-35596019
PURPOSE: Living kidney donors (LKD) partially compensate the initial loss of glomerular filtration rate (GFR), a phenomenon known as renal functional reserve (RFR). RFR is reduced in the elderly, a population with increased prevalence of chronic kidney disease. We hypothesized that the selected, healthy population of LKD, would specifically inform about the physiological determinants of the RFR and studied it using measured GFR (mGFR). METHODS: We retrospectively analyzed pre-donation and post-donation mGFR in 76 LKD from Tenon Hospital (Paris, France) between 2002 and 2018. In addition to GFR measurements, we collected pre-donation morphologic parameters, demographic data, and kidney volumes. RESULTS: Mean pre-donation mGFR was 90.11 ± 12.64 mL/min/1.73 m2 and decreased to 61.26 ± 9.57 mL/min/1.73 m2 1 year after donation. Pre-donation mGFR correlated with age (p = 0.0003), total kidney volume (p = 0.0004) and pre-donation serum creatinine (p = 0.0453). Pre-donation mGFR strongly predicted 1-year post-donation mGFR. Mean RFR (increase in GFR of the remnant kidney between pre-donation and post-donation) was 36.67 ± 16.67% 1 year after donation. In the multivariate linear model, RFR was negatively correlated to total kidney volume (p = 0.02) but not with age or pre-donation serum creatinine. CONCLUSIONS: We found that pre-donation mGFR decreases with age and identified low total kidney volume as a predictor of RFR in healthy individuals. This suggests an adaptative and reversible decrease in kidney function rather than age-related damage. Older subjects may have reduced metabolic requirements with subsequent reduction in glomerular filtration and kidney volume and preserved RFR. Therefore, low GFR in older subjects should not preclude kidney donation.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Rim Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Revista: World J Urol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: França País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Transplante de Rim Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans Idioma: En Revista: World J Urol Ano de publicação: 2022 Tipo de documento: Article País de afiliação: França País de publicação: Alemanha