Kidney Week

Abstract: TH-PO904

Association of Pre-Donation Kidney Length with Estimated Glomerular Filtration Rate in Living Kidney Donors

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

• Kunupakan, Sasithorn, University of California Irvine, Irvine, United States

Sasithorn Kunupakan,

• Wattanachayakul, Phuuwadith, University of California Irvine, Irvine, California, United States

Phuuwadith Wattanachayakul,

• Kittrakulrat, Jathurong, University of California Irvine, Irvine, California, United States

Jathurong Kittrakulrat,

• Tantisattamo, Ekamol, University of California Irvine, Irvine, California, United States

Ekamol Tantisattamo,

Background

The compensatory mechanism increases estimated glomerular filtration rate (eGFR) after unilateral native nephrectomy. Predicting post-living kidney donation eGFR may depend on pre-donation factors, including kidney length. We aimed to examine the association between kidney length and post-donation eGFR.

Methods

A single-center cross-sectional study included adult living kidney donors (LKD) between February 2015 and January 2023. The association between the pre-donation kidney length (by CT scan)/height ratio (LHR) of the remaining kidney and post-donation eGFR was examined by multiple linear regression analyses.

Results

Of 136 LKD, the mean±SD age was 47±12 years and 59% were female. The median (IQR) of LHR was 6.34 (6.07, 6.71) cm/m. Mean pre-donation creatinine clearance (CrCl) were 130.9±32.8 ml/min, followed-up (F/U) eGFR at 1 wk, 6-, 12-, and 24-mos post-donation were 67.8±15.1, 70.7±16.2, 71.3±15.4, and 73.6±16.3 ml/min/1.73 m²,respectively. The eGFR increased from quartile 1 to 4 of LHR for all F/U periods (P_trend <0.001, 0.004, 0.004, and 0.003; Figure 1A). Each 0.1 cm/m increase in LHR was associated with 0.9 – 1.2 ml/min/1.73 m² greater eGFR of all post-donation F/U periods with the lowest and highest eGFR at 12 and 24 mos, respectively(β (95%CI) _1wk 11.8 (6.1, 17.5); β_6mo 11.3 (4.7, 17.9); β_12mo 9.3 (3.2, 15.5); β_24mo 12.0 (4.8, 19.2); Figure 1B-1D). After adjusting for age, sex, race, pre-donation BMI, CrCl, urinary microalbumin:urinary creatinine ratio, systolic and diastolic blood pressures, the magnitude and direction of the LHR – eGFR association remains (β_1wk 11.2 (5.8, 16.7); β_6mo 12.1 (6.5, 17.8); β_12mo 10.5 (4.6, 16.3); β_24mo 15.1 (7.7, 22.5)). There was no effect modification observed in all major covariates for the LHR – eGFR association.

Conclusion

Pre-donation LHR is positively associated with post-donation eGFR during 24 mos F/U, suggesting its relevance in selecting potential LKD with low eGFR.