Renal cysts found during the evaluation of living kidney donor (LKD) candidates are often regarded as benign. However, it is possible that these structural abnormalities may impact renal function among LKDs, and their implications for long-term renal function are unknown. We characterized the prevalence of renal cysts discovered during donor evaluation at our center and their association with post-donation eGFR trajectory.

METHODS: We studied LKDs who donated at our center between 2000-2005, had pre-donation CT imaging, and had at least one post-donation serum creatinine value (N=322). We compared post-donation renal function (eGFR) among LKDs with and without cysts using mixed-effect linear regression adjusting for pre-donation characteristics (age, sex, race, eGFR, BMI, and college education).

RESULTS: The prevalence of pre-donation renal cysts was 25.5% among LKDs in our cohort. LKDs with cysts were older (p<0.001) and had slightly lower pre-donation eGFR than those without cysts (median: 96 vs. 101mL/min/1.73m², p<0.01) (Table 1). LKDs were followed for a median (IQR) of 8.6 (5.4-11.1) years. Without adjustment, cysts were associated with 4.05mL/min/1.73m² lower post-donation eGFR (difference= _1.074.05_7.03, p<0.01) (Figure 2). However, after adjustment, there was no difference in post-donation eGFR trajectory (p=0.8). Within-individual variance accounted for 48% of the overall variation (intra-class correlation: _0.420.48_0.54).

CONCLUSION: In this single-center study of living kidney donors, pre-donation renal cysts were associated with slightly lower post-donation eGFR on average; however, they were not associated with long-term differences in post-donation renal function trajectory after adjusting for donor characteristics. These findings are reassuring for current practices in donor evaluation and management.

CITATION INFORMATION: Waldram M., Thomas A., Muzaale A., Holscher C., Nguyen A., Halpern S., Anjum S., Alejo J., Boyarsky B., Ottman S., Garonzik-Wang J., Segev D., Massie A. Long-Term Renal Function in Living Kidney Donors with Renal Cysts Am J Transplant. 2017;17 (suppl 3).

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