Abstract: TH-PO902
Risk of Developing CKD Following Live Kidney Donation: A Prospective Observational Study
Session Information
- Transplantation: Donation and Access
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Erandika, Naduni, National Hospital Kandy, Kandy, Central, Sri Lanka
- Abeysekera, Rajitha Asanga, University of Peradeniya Faculty of Medicine, Peradeniya, Central, Sri Lanka
- Wijetunge, Sulochana, University of Peradeniya Faculty of Medicine, Peradeniya, Central, Sri Lanka
- Abeysundara, Hemalika T.k., University of Peradeniya Faculty of Science, Peradeniya, Central, Sri Lanka
- Nanayakkara, Nishantha, National Hospital Kandy, Kandy, Central, Sri Lanka
Background
Chronic Kidney Disease (CKD) is a major concern among live kidney donors. Understanding the risk factors to development of CKD is crucial for optimizing donor selection and post-donation management. This study is aimed to identify the incidence and risk factors associated with development of CKD after one year kidney donation.
Methods
This prospective observational study was conducted using 57 live kidney donors at the National Hospital, Kandy, Sri Lanka. Pre-operative demographic, clinical and pre-implantation kidney biopsy (bx) findings of live donors were examined. We evaluated the estimated glomerular filtration rate (eGFR) using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Donors who had eGFR of less than 60 mL/min per 1.73 m2 at one-year post kidney donation considered as development of CKD among kidney donors.
Results
The mean age of the participants was 47.8 years, with males representing 50.9% (n=29) of the study cohort. 19.3% (n=11) of the donors developed CKD at the end of one year post donation. According to Kaplan-Meir analysis, there is a significant decrease in survival of donors with smoking (p=0.001), alcohol consumption (p=0.016), past medical history of hypertension (p=0.002), presence of donor/recipient relationship, (p=0.018), more than 50 years of age (p=0.005), presence of tubular atrophy (TA) (p=0.001), interstitial fibrosis (p=0.006), interstitial inflammation (p=0.007 and high activity index (p=0.04) in pre-implantation bx. Logistic regression analysis showed that, presence of TA (p=0.007) in histology and having a related donor (p=0.009) had 2.4 and 2.5 times higher risk of developing CKD at final follow-up respectively.
Conclusion
Incidence of development of CKD was high among live kidney donors in a cohort of Sri Lanka with highest risk of being presence with TA in pre-implantation bx and presence of being related kidney donor. These findings emphasize the requirement of a better biomarker to predict the risk of complications as the kidney biopsy is not applicable to do in routine practice. Indeed, the implementation of targeted interventions and follow-up protocols can potentially mitigate the risk of CKD progression among live kidney donors.