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Kidney Week

Abstract: PO2080

Remnant Kidney Hypertrophy Is Negatively Associated with Albuminuria After Donor Nephrectomy

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Ogata, Masatomo, St. Marianna University School of Medicine, Kawasaki, Japan
  • Miyauchi, Takamasa, St. Marianna University School of Medicine, Kawasaki, Japan
  • Osako, Kiyomi, St. Marianna University School of Medicine, Kawasaki, Japan
  • Terashita, Maho, St. Marianna University School of Medicine, Kawasaki, Japan
  • Imai, Naohiko, St. Marianna University School of Medicine, Kawasaki, Japan
  • Shibagaki, Yugo, St. Marianna University School of Medicine, Kawasaki, Japan
  • Yazawa, Masahiko, St. Marianna University School of Medicine, Kawasaki, Japan
Background

Glomerular ultrafiltration pressure in the remnant kidney remains after donor nephrectomy by the compensatory increase in the glomerular ultrafiltration coefficient, consisting of renal blood flow and cortex volume, namely compensatory hypertrophy. This compensation may be related to the protection for the newly or progressively incident albuminuria, a well-known predictor for kidney damage. To elucidate this theory, we analyzed the relationship between the percentage of change in the remnant kidney volume over 1-year post donation and albuminuria after donation.

Methods

This was a retrospective observational study, with 36 living donors who underwent nephrectomy at our hospital between 2011–2018. The mean age of the participants was 59±8 years and 72% of them were female. We reviewed the computed tomography before and 1 year after donation to calculate the change (%) in remnant kidney volume and investigated the associations with absolute values and relative changes in urinary albumin to creatinine ratio (UACR) 1, 2, and 3 years after donation. Pearson’s correlation coefficients was used for the significance of association. This study is approved by Institutional Review Committee of St. Marianna University School of Medicine (No. 1574).

Results

Mean remnant kidney volume change percentage 1-year after donation was 24.2±8.0%. Although statistically non-significant, negative associations were suggested between the change in remnant kidney volume and both the absolute values of and % change in UACR (Figure).

Conclusion

Although relationships between change in remnant kidney volume and albuminuria were statistically insignificant due to the small sample size and analysis for not at-risk population, consistently negative associations would suggest the clinical significance. To assess the long-term safety of living donors, the focus might be on whether the remnant kidney can be hypertrophic by compensation.