Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: to assess renal function among living kidney donors in Brazil, where the population is greatly race-mixed.
*Methods: This is a retrospective single-center cohort study involving 397 individuals who had the donation effected between 2002-2014 and who were followed until 2017. Renal function was measured by creatinine clearance (24h urine sample), MDRD and CKD-Epi equation, all of them expressed as ml/min/1.73m2. The correlations models were performed by Pearson or Spearman R, depending on distribution. The outlier values were treated by ROUT test (Q=10%). Renal function variation was assessed by a generalized mixed model
*Results: the donors baseline data were: 43.4±10.5 years old, 60.2% female, 11.6% black race; body mass index was 25.6±3.8 kg/m2, obesity- 37.1%, hypertension- 2.1% and smoking report- 15.5%; most frequently the donors were siblings (44.8%) or parents (26.2%) of recipients. Baseline kidney function evaluation is depictured in the table. “$$tabel_”
|Serum creatinine (mg/dL)||0.78±0.16|
|Urinary mass of creatinine (mg/kg/day)||20.4±4.9|
Considering the baseline kidney function, the creatinine mass was related with CrCl (R2=0.34, p<0.0001), but it wasn’t correlated with MDRD or CKD-Epi. The CrCl measured by 24h urine sample was significantly correlated with CKD-Epi (R2= 01.6; p<0.0001), but wasn’t with MDRD. Finally, MDRD had significant correlation with CKD-Epi (R2= 0.21, p<0.0001), however this patter was due to donors who had MDRD < 60 (R2=0,90, p<0.0001). When we analyzed ranges of MDRD above 60, no one correlation was significant. As this is a retrospective study, the donors who had MDRD < 60 had the donation effected because they had normal CrCl. Two or three days after nephrectomy, the CDK-epi decreased to 70.3±16.7, reaching a negative slope of 32.9±16.4 (compared to baseline, p<0.0001). The baseline CKD-Epi was significantly related with the early negative slope: R= -0.43; CI95%= -0.51 a -0.34; p<0.0001. One year after donation, CKD-Epi was 70.7±15.9, without difference from early post-donation function. In the next following 5 years, renal function was stable, however a very discreet positive slope was detected between the 1stand 2ndyears after nephrectomy: 0.17 (-4.7; 8.16), p=0.015. The cumulative incidence of patients with eGFR<60 5-year post-donation was 19.0%. The mean follow-up was 87.1 (51.3; 126.4) months
*Conclusions: Our results have suggested that despite of we have a mixed population, the best performance was achieved with CKD-Epi. Moreover, MDRD equation should be avoid in individual who had eGFR > 60.
To cite this abstract in AMA style:Requião-Moura LR, Bicalho PR, Pacheco-Silva A. Kidney Function Evaluation Among Living Donors In A Multiracial Population. The Results From A Brazilian Single-center Cohort Study. [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-function-evaluation-among-living-donors-in-a-multiracial-population-the-results-from-a-brazilian-single-center-cohort-study/. Accessed March 9, 2021.
« Back to 2019 American Transplant Congress