Early increase in single-kidney glomerular filtration rate after living kidney donation predicts long-term kidney function
Copyright © 2022 International Society of Nephrology. Published by Elsevier Inc. All rights reserved..
Single-kidney glomerular filtration rate (GFR) increases after living kidney donation due to compensatory hyperfiltration and structural changes. The implications of inter-individual variability in this increase in single-kidney GFR are unknown. Here, we aimed to identify determinants of the increase in single-kidney GFR at three-month postdonation, and to investigate its relationship with long-term kidney function. In a cohort study in 1024 donors, we found considerable inter-individual variability of the early increase in remaining single-kidney estimated GFR (eGFR) (median [25th-75th percentile]) 12 [8-18] mL/min/1.73m2. Predonation eGFR, age, and cortical kidney volume measured by CT were the main determinants of the early postdonation increase in single-kidney eGFR. Individuals with a stronger early increase in single-kidney eGFR had a significantly higher five-year postdonation eGFR, independent of predonation eGFR and age. Addition of the postdonation increase in single-kidney eGFR to a model including predonation eGFR and age significantly improved prediction of a five-year postdonation eGFR under 50 mL/min/1.73m2. Results at ten-year follow-up were comparable, while accounting for left-right differences in kidney volume did not materially change the results. Internal validation using 125I-iothalamate-based measured GFR in 529 donors and external validation using eGFR data in 647 donors yielded highly similar results. Thus, individuals with a more pronounced increase in single-kidney GFR had better long-term kidney function, independent of predonation GFR and age. Hence, the early postdonation increase in single-kidney GFR, considered indicative for kidney reserve capacity, may have additional value to eGFR and age to personalize follow-up intensity after living kidney donation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:101 |
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| Enthalten in: |
Kidney international - 101(2022), 6 vom: 05. Juni, Seite 1251-1259 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
van der Weijden, Jessica [VerfasserIn] |
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| Links: |
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| Themen: |
Glomerular filtration rate |
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| Anmerkungen: |
Date Completed 24.05.2022 Date Revised 10.07.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.kint.2022.01.034 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM337590923 |
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| 520 | |a Copyright © 2022 International Society of Nephrology. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Single-kidney glomerular filtration rate (GFR) increases after living kidney donation due to compensatory hyperfiltration and structural changes. The implications of inter-individual variability in this increase in single-kidney GFR are unknown. Here, we aimed to identify determinants of the increase in single-kidney GFR at three-month postdonation, and to investigate its relationship with long-term kidney function. In a cohort study in 1024 donors, we found considerable inter-individual variability of the early increase in remaining single-kidney estimated GFR (eGFR) (median [25th-75th percentile]) 12 [8-18] mL/min/1.73m2. Predonation eGFR, age, and cortical kidney volume measured by CT were the main determinants of the early postdonation increase in single-kidney eGFR. Individuals with a stronger early increase in single-kidney eGFR had a significantly higher five-year postdonation eGFR, independent of predonation eGFR and age. Addition of the postdonation increase in single-kidney eGFR to a model including predonation eGFR and age significantly improved prediction of a five-year postdonation eGFR under 50 mL/min/1.73m2. Results at ten-year follow-up were comparable, while accounting for left-right differences in kidney volume did not materially change the results. Internal validation using 125I-iothalamate-based measured GFR in 529 donors and external validation using eGFR data in 647 donors yielded highly similar results. Thus, individuals with a more pronounced increase in single-kidney GFR had better long-term kidney function, independent of predonation GFR and age. Hence, the early postdonation increase in single-kidney GFR, considered indicative for kidney reserve capacity, may have additional value to eGFR and age to personalize follow-up intensity after living kidney donation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a glomerular filtration rate | |
| 650 | 4 | |a living kidney donation | |
| 650 | 4 | |a postdonation adaptation | |
| 650 | 4 | |a postdonation outcomes | |
| 650 | 4 | |a renal functional reserve | |
| 700 | 1 | |a Mahesh, Shekar V K |e verfasserin |4 aut | |
| 700 | 1 | |a van Londen, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Bakker, Stephan J L |e verfasserin |4 aut | |
| 700 | 1 | |a Sanders, Jan-Stephan |e verfasserin |4 aut | |
| 700 | 1 | |a Navis, Gerjan |e verfasserin |4 aut | |
| 700 | 1 | |a Pol, Robert A |e verfasserin |4 aut | |
| 700 | 1 | |a Roodnat, Joke I |e verfasserin |4 aut | |
| 700 | 1 | |a Kho, Marcia M L |e verfasserin |4 aut | |
| 700 | 1 | |a Yakar, Derya |e verfasserin |4 aut | |
| 700 | 1 | |a Kwee, Thomas C |e verfasserin |4 aut | |
| 700 | 1 | |a Nolte, Ilja M |e verfasserin |4 aut | |
| 700 | 1 | |a Berger, Stefan P |e verfasserin |4 aut | |
| 700 | 1 | |a De Borst, Martin H |e verfasserin |4 aut | |
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