Kidney Week

Abstract: PUB392

Tubular Function After Elective Nephrectomy in Living Kidney Donors

Session Information

• Publication Only

Category: CKD (Non-Dialysis)

• 2303 CKD (Non-Dialysis): Mechanisms

Authors

• Castro Martínez, Daniela, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Daniela Castro Martínez

• Fernandez Yepez, Ana K., Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Ana K. Fernandez Yepez, MD

• Del Rio Soroko, Luhana, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Luhana Del Rio Soroko, MD

• Hernández Carrasco, Adriana, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Adriana Hernández Carrasco, MD

• Carabeo, Grecia Bejarano, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Grecia Bejarano Carabeo, MD

• Meléndez Mendoza, Adrián, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Adrián Meléndez Mendoza, MD

• Rodriguez-Iturbe, Bernardo, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Bernardo Rodriguez-Iturbe, MD

• Madero, Magdalena, Instituto Nacional de Cardiologia Ignacio Chavez, State of Mexico, Méx., Mexico

Magdalena Madero, MD

Background

Kidney donor eligibility traditionally relies on measures of glomerular function , while tubular function is often overlooked. We aimed to determine whether nephron loss alters the tubular stress response and how does nephrectomy affect biomarkers of tubular injury or function

Methods

9 living kidney donors from the “Instituto Nacional de Cardiología Ignacio Chávez” were evaluated at baseline and 3 months after nephrectomy . Donors were studied hourly for 4 hours after ingestion of 5g of creatinine and 1 mg/kg of furosemide intravenously to stimulate tubular secretion of creatinine (TScr) and furosemide (TSfuro) by OCTs and OATs, respectively. Ultrasound was used to confirm complete bladder emptying. Glomerular filtration rate was measured by Iohexol clearance, urinary furosemide by HPLC and creatinine by autoanalyzer while the kidney function and injury biomarkers: Urinary Epidermal growth factor (EGF), Ammonium (NH4), Alpha 1 Microglobulin (A1MG), Uromodulin (UMOD), kidney injury molecule 1 (KIM-1) and interleukin 18 (IL-18) were assessed by ELISA with 2-plex and U-plex kits in the first hour were maximal stimulation of TScr and TSfuro were observed. Normality of variables were assessed, followed by paired t-test or Wilcoxon signed-rank test, as appropriate comparing baseline and 3-month post-nephrectomy data.

Results

The a mean age was 41 y (20-65yrs) and 60% were female. Based on previous studies we included first hour values were maximal stimuli of OCT and OAT were found. Three months after nephrectomy mGFR decreased 35.1 ± 12.8ml/min/1.73m². There was a trend towards a decrease in TScr. There was significant increase in markers of kidney damage (KIM 1 and IL18) and markers of kidney function (alfa1MG and indoxyl sulphate). (Table)

Conclusion

Donor nephrectomy is associated with a reduced response to oral creatinine secretion (TSCr) and a significant increase in some markers of tubular damage and function.

Funding

• Clinical Revenue Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025hpdr8w8h