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Abstract: SA-PO813

Evaluation of Measured Glomerular Filtration Rate in Living Related Kidney Donors Before and After Donor Nephrectomy

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Dighe, Tushar Anil, Dr.D.Y.Patil Medical College,Hospital and Research Centre,Pimpri,Pune,Dr DY Patil Vidyapeeth,Pune,India, Pune, India
  • Chavan, Abhijit Suresh, Dr.D.Y.Patil Medical College,Hospital and Research Centre,Pimpri,Pune,Dr DY Patil Vidyapeeth,Pune,India, Pune, India
  • Bale, Charan Bhadrappa, Dr.D.Y.Patil Medical College,Hospital and Research Centre,Pimpri,Pune,Dr DY Patil Vidyapeeth,Pune,India, Pune, India
  • Wakhare, Pavan, Dr.D.Y.Patil Medical College,Hospital and Research Centre,Pimpri,Pune,Dr DY Patil Vidyapeeth,Pune,India, Pune, India
  • Shinde, Nilesh, Dr.D.Y.Patil Medical College,Hospital and Research Centre,Pimpri,Pune,Dr DY Patil Vidyapeeth,Pune,India, Pune, India
  • Kulkarni, Akshay Rajiv, Dr.D.Y.Patil Medical College,Hospital and Research Centre,Pimpri,Pune,Dr DY Patil Vidyapeeth,Pune,India, Pune, India
  • Sajgure, Atul, Dr.D.Y.Patil Medical College,Hospital and Research Centre,Pimpri,Pune,Dr DY Patil Vidyapeeth,Pune,India, Pune, India
Background

Understanding the pathophysiologic effects of kidney donation is important for judging donor safety and analysing compensatory changes occurring in remnant kidney after donation. If remnant kidney undergoes inadequate compensatory changes in Glomerular filtration rate (GFR), it can have undesirable effects on long term health of donors.

Methods

We performed a prospective observational study of 10 subjects who underwent Nephrectomy for living related kidney transplant over a period of 1 year in tertiary care hospital. It was approved by out Institutional Ethics committee. Baseline evaluation of all subjects was done 10 to14 weeks prior and at 11 to13 weeks after nephrectomy, which included Tc-99m DTPA scintigraphy for measured GFR, Spot Urine Albumin Creatinine ratio and laboratory parameters(serum creatinine, urea and electrolytes). Lab parameters, spot urine albumin creatinine ratio and GFR by DTPA scan pre(10-14 weeks) and post (11-13 weeks) nephrectomy were compared and analysed. P values were calculated using paired t test .

Results

Mean age of donors was 49.1±15.38 (range 23-73 ) years.Pre-Nephrectomy, mean total GFR by DTPA scan was 101.7 ml/min (±9.28) which reduced to 61.13 ml/min (±5.87),a 40% decline in total GFR was noticed,11-13 weeks after Nephrectomy. Mean serum creatinine pre and post donor Nephrectomy was 0.73 mg/dl (±0.94) and 0.96mg/dl(±0.54) respectively,with a significant mean rise of 0.23 mg/dl.Mean GFR of the remnant Kidney increased by + 9.64 ml/min (± 6.36),11-13 weeks post Donation. Urinary Albumin Creatinine ratio pre and post Nephrectomy was 15.25 (±17.08) and 22.19 (±20.45) ug/mg respectively.

Conclusion

The mean total GFR reduced significantly by 40.5%(P<0.0001), however a significant increase in mean GFR of remnant kidney by 9.64 ml/min(±6.36) (P<0.001) 11 to 13 weeks Post Nephrectomy was seen. This average increase in GFR was not significantly higher in young donors as compared to older donors(P<0.9). There was no siginificant difference in Urinary Albumin creatinine ratio pre and post nephrectomy(P<0.06).A better understanding of trends and variations observed in post donation GFR over time can aid in analysing effect of compensatory changes in GFR, which can benefit Living related kidney donors, in monitoring and patient care.