Kidney Week

Abstract: TH-PO1171

Suboptimal Renal Recovery and Progressive CKD After Living Kidney Donation

Session Information

• Transplantation: Clinical - Pretransplant Management
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1902 Transplantation: Clinical

Authors

• Kim, Yaerim, Seoul National University Hospital, Seoul, Korea (the Republic of)

Yaerim Kim,

• Kang, Eunjeong, Seoul National University Hospital, Seoul, Korea (the Republic of)

Eunjeong Kang,

• Paek, Jin hyuk, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Jin hyuk Paek,

• Park, Woo Yeong, Dongsan Medical Center, Daegu, Korea (the Republic of)

Woo Yeong Park,

• Han, Seungyeup, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Seungyeup Han,

• Han, Miyeun, Pusan National University Hospital, Busan, Korea (the Republic of)

Miyeun Han,

• Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)

Jung Pyo Lee,

• Chae, Dong-Wan, Seoul National University Bundang Hospital, Seongnam-si, Korea (the Republic of)

Dong-Wan Chae,

• Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)

Dong Ki Kim,

• Joo, Kwon Wook, Seoul National University Hospital, Seoul, Korea (the Republic of)

Kwon Wook Joo,

• Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Yon Su Kim,

• Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Hajeong Lee,

Background

Post-operative renal recovery after nephrectomy is a substantial problem to be addressed in living kidney donors. Herein, we explored factors associated with renal recovery and progression to chronic kidney disease (CKD) in living kidney donors.

Methods

Kidney donors who underwent nephrectomy in 5 different tertiary hospital were retrospectively reviewed. We extracted donors who had estimated glomerular filtration rate (eGFR) at 1 month after kidney donation with follow-up period over one year. Percent change of eGFR from initial to one month after donation was calculated. The sub-optimal renal recovery was defined as percent change of eGFR at 1 month after donation with the lowest quartile range. The development of CKD, latest eGFR < 60 ml/min/m² was the clinical end-point. Cox-regression and logistic regression analysis were used to determine the risk factor related with sub-optimal renal recovery and progressive CKD.

Results

In total, 883 donors were included in the study. The mean follow-up period was 59.0 ± 50.3 months. Of which 129 donors progressed to CKD, eGFR <60 ml/min/m². A patient with CKD showed older age, male sex, higher body mass index, higher hemoglobin, calcium, uric acid, cholesterol, lower eGFR, higher percent change in eGFR at 1 month after donation. Also, older age (adjusted HR 1.02, 95% CI 1.00-1.04, p=0.048), initial eGFR (adjusted HR 0.95, 95% CI 0.93-0.96, p <0.001) and decreased percent in eGFR at 1 month(Q3 adjusted HR 3.54, 95% CI 1.97-6.36, p <0.001; Q4 adjusted HR 5.71, 95% CI 3.10-10.54, p <0.001)) were the significant risk factors for development of CKD in multivariate Cox-regression analysis.

Conclusion

Percent change of eGFR at 1 month after donation is significant risk factor for development of CKD. Earnest evaluation and management to reduce eGFR decreasing at 1 month after donation could be helpful in improving long-term renal outcomes in living kidney donors.