*Purpose: Predicting post-donation kidney function precisely is considerably beneficial for both candidates of living-related kidney donors and their physicians when judging the feasibility of kidney donation. The aim of this study is to explore the optimum model using preoperative factors that can predict eGFR at a year after kidney donation. We investigated the significance of preserved kidney volume in combination with other variables.

*Methods: We retrospectively reviewed medical records of 101 living-related kidney donors. The evaluated preoperative factors were baseline eGFR, age, BMI, the use of antihypertensive drug and calculated kidney volume of 3-dimensional reconstruction by thin-sliced enhanced computed tomography (CT) scan.

*Results: Total kidney volume which was calculated from CT scan data was significantly correlated with preoperative eGFR (Spearman’s correlation of 0.317, p = 0.0029). The univariate analysis revealed that age and BMI significantly negatively correlated with eGFR at a year post-donation (correlation coefficient = -0.353 and -0.788, p = 0.0002 and 0.0118, respectively). Preoperative eGFR and preserved kidney volume significantly positively correlated with eGFR at a year post-donation (correlation coefficient = 0.610 and 0.086, p < 0.0001 and 0.0076, respectively). eGFR at a year post-donation in the group taking anti-hypertensive drugs was significantly lower than that in the group without anti-hypertensive drugs (Mann-Whitney U test, p = 0.0132). Multiple regression analysis employing sex, age, BMI, preoperative eGFR, preserved kidney volume, and the use of antihypertensive drug revealed that BMI, preoperative eGFR, and preserved kidney volume were significant predictive factors (R²= 0.752, p < 0.0001). The predictive equation was as follows; predicted post-donor eGFR = 20.22 +0.557×preope eGFR -0.694×BMI +0.057×preserved kidney volume (cm³). Then we evaluated this predictive model in the validation cohort of 42 kidney donors. The significant correlation between the predicted postoperative eGFR and the exact postoperative eGFR was also observed by employing the predictive equation described above in the validation cohort (R²= 0.585, p<0.0001).

*Conclusions: In conclusion, donor kidney function a year after the kidney donation can be predicted by the combination of BMI and preoperative eGFR with preserved kidney volume. This prediction may be useful for both donor candidates and their physicians to assure the kidney donation would not imperil health of donors in the rest of their life.

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