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Kidney Week

Abstract: TH-PO905

Males Show Greater eGFR Recovery than Females Following Kidney Donation

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Hilvert, Austin M., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Grice, Jared V., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Mcgonigle, Trey William, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Huang, Shi, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Vivek, Niketna, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Ale Ali, Hamideh, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Concepcion, Beatrice P., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Langone, Anthony J., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Schaefer, Heidi M., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Forbes, Rachel C., Vanderbilt University Medical Center, Nashville, Tennessee, United States
Background

Living donor kidney transplantation is the optimal treatment for end-stage kidney disease and requires donor risk assessment. More data is needed to understand kidney function recovery after donation. We aimed to assess the impact of BMI, age, and sex on post-donation estimated glomerular filtration rate (eGFR) in kidney donors over 2 years.

Methods

We analyzed data from 178 kidney donors who underwent living donor nephrectomy at a single medical center between Nov. 2017 and Jan. 2022. Follow-up visits occurred at approximate 1-month, 6-month, 12-month, and 24-month intervals. eGFR was calculated using the CKD-EPI equation (2021) at each timepoint. We utilized Friedman’s test to identify variations in eGFR over the follow-up periods. Relationships between post-donation eGFR and BMI, age, and sex were explored using a generalized least squares model with AR1 error structure. The resulting relationships were plotted using model-estimated eGFR values.

Results

The study included 57 male and 121 female kidney donors. Median pre-donation eGFR was similar for males and females (98.85 vs 94.59, p=0.184). Pre-donation eGFR, BMI, and age did not significantly affect eGFR trajectories (p=0.89, p=0.37, and p=0.17, respectively). However, sex appears to significantly affect eGFR trajectories. As seen in Figure 1, despite the initially lower eGFR (59.13 vs. 65.21, p<0.001), males showed a significantly greater eGFR recovery than females through 24-month follow-up (p=0.003).

Conclusion

Our study suggests that male kidney donors recover kidney function to a greater degree than females after donation. These findings may have implications for donor evaluation, pre-operative patient counseling, and sex-specific monitoring. Further studies are needed to investigate underlying mechanisms and potential interventions to enhance eGFR recovery in both male and female kidney donors.