Date: Tuesday, June 4, 2019
Session Name: Concurrent Session: Kidney Living Donor: Selection
Session Time: 4:30pm-6:00pm
Presentation Time: 5:18pm-5:30pm
Location: Ballroom A
*Purpose: Accurate post-donation renal function prediction 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 predictor of pre-donation measured GFR (mGFR) and 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 916 living kidney donors, eGFR (Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)) and mGFR (125I-iothalamate) were measured before and 3 months after donation. Bayesian statistics were used to calculate the probability of having a post-donation mGFR above thresholds of 40, 50, and 60 ml/min/1.73m2 according to different pre-donation eGFR, age and sex categories.
*Results: Donor age was 52±11 years and 49% were male. Pre-donation eGFR was 88±14 mL/min/1.73m2 and pre-donation mGFR/BSA was 101±16 ml/min/1.73m2 respectively. Post-donation mGFR/BSA was 64±11 ml/min/1.73m2. All donors had a >95% probability to reach a post-donation mGFR ≥40 ml/min/1.73m2. All donors with a pre-donation eGFR ≥90 ml/min/1.73m2 had a posttest probability >95% of achieving a post-donation mGFR ≥50 ml/min/1.73m2. A greater variability in posttest probabilities was seen for the post-donation mGFR threshold set at 60 ml/min/1.73m2, with older donors requiring higher pre-donation eGFR values to reach a posttest probability >95%.
*Conclusions: This study shows how pre-donation eGFR can be used to predict post-donation mGFR, taking nephrectomy into account. Compared to young donors, the probability of reaching a high post-donation mGFR had a higher variability for older donors. This model can be used as a supportive device for the clinical decision-making of the individual living kidney donor.
To cite this abstract in AMA style:Weijden Jvander, Londen Mvan, Said MY, Bakker SJ, Berger SP, Navis G, Borst MHde. Estimated Glomerular Filtration Rate at Donor Screening to Predict Measured Glomerular Filtration Rate after Living Kidney Donation [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/estimated-glomerular-filtration-rate-at-donor-screening-to-predict-measured-glomerular-filtration-rate-after-living-kidney-donation/. Accessed February 29, 2020.
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