Study Purpose: Accurate pre-donation renal function estimation is important to minimize the risk of future severe renal function impairment in living kidney donors. Recent studies focused on pre-donation estimated GFR (eGFR) as a predictor of measured GFR (mGFR), but did not account for the effect of nephrectomy. Therefore, in this study, we aimed to identify the predictive value of pre-donation eGFR for post-donation mGFR.

Methods: In 873 living kidney donors, eGFR (CKD-EPI formula) and mGFR (125I-iothalamate) were measured before and 3 months after donation. Bayesian statistics were used to calculate for different pre-donation eGFR categories the probability of having a post-donation mGFR above the thresholds 40, 45, 50, 55 and 60 mL/min/1.73m².

Results: Mean donor age was 51.6±1and 48% were male. Mean pre-donation eGFR was 88±14 mL/min/1.73m² and mean pre-donation mGFR/BSA was 102±16 ml/min/1.73m² respectively. Mean post-donation mGFR/BSA was 65±12 ml/min/1.73m². In order to achieve a post-donation eGFR >40ml/min/1.73m2 with a chance of 95%, a pre-donation eGFR >68.8 ml/min/1.73m2 was necessary. This was present in 91% of donors. A pre-donation eGFR>94.2 mL/min/1.73m² was needed to reach a post-donation mGFR>50 mL/min/1.73m² with a probability of 95%. This was present in 33% of the donors.

Conclusion: This study shows how pre-donation eGFR could be used to identify donors that do not need mGFR measurements to be accepted for living kidney donation.

CITATION INFORMATION: van Londen M., van der Weijden J., Bakker S., Berger S., Sanders J., Navis G., de Borst M. Estimated GFR at Donor Screening and Achieved Measured GFR after Living Kidney Donation Am J Transplant. 2017;17 (suppl 3).

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