Evaluation of renal function in a specific population of living kidney donors

J Ren Care. 2017 Jun;43(2):114-120. doi: 10.1111/jorc.12198. Epub 2017 Feb 24.

Abstract

Background: The increase in candidates for kidney transplant has led to growth in the number of living donor transplants. Therefore, studies that adequately evaluate the possible long-term consequences of elective transplant nephrectomy are needed.

Objective: To evaluate the possible long-term adverse effects of transplant nephrectomy on the renal function of living kidney donors.

Design: A cross-sectional study.

Participants: Thirty-three living kidney donors registered in the transplant programme of a centre in Alagoas, Brazil.

Measurements: Demographic characteristics, anthropometric measures, clinical data and biomarkers (creatinine, eGFR, microalbuminuria, cholesterol and triglycerides) were measured. Creatinine clearance was calculated using the Cockcroft-Gault and Modification of Diet in Renal Disease formulae.

Results: Of the 33 individuals, 63.63% were female, and the median age was 45 years. Additionally, 24.24% of these individuals had altered blood pressure, 39.39% had altered abdominal circumference (AC) and 36.36% were obese, with a body mass index ≥30. Furthermore, 33.33% of these individuals had elevated triglyceride levels. The average eGFR was 97.33 (33.03-175.9) ml/min/1.73 m2 (CG) and 84.14 (29.4-131) ml/min/1.73 m2 (MDRD). The microalbuminuria level was altered in 12.12% patients.

Conclusion: Kidney donation is unquestionably a safe procedure. However, a better understanding of the long-term consequences of living donor kidney transplantation is still needed. This knowledge may have important implications for the follow-up of these patients. Our study has demonstrated a non-negligible presence of an early marker of glomerular injury and a decrease in the GFR of some patients, thereby reinforcing the proposal for long-term follow-up of living kidney donors.

Keywords: Chronic kidney disease; Kidney transplantation; Living donors.

MeSH terms

  • Adult
  • Aged
  • Albuminuria / urine
  • Blood Pressure
  • Body Mass Index
  • Brazil
  • Creatinine / analysis
  • Creatinine / blood
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney / physiology*
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Living Donors / statistics & numerical data*
  • Long Term Adverse Effects
  • Male
  • Middle Aged
  • Nephrectomy / rehabilitation
  • Nephrectomy / standards
  • Tissue and Organ Harvesting / adverse effects

Substances

  • Creatinine