Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
- The Combination of Area under Curve of Estimated Glomerular Filtration Rate for 2 Years and Annual Rate Change of Estimated Glomerular Filtration Rate Predicts Long-Term Graft Survival in Kidney Transplants
- Risk Factors and 2 Year Outcomes of Low Estimated Glomerular Filtration Rate in the Immediate Post-Operative Period for Living Kidney Donors.
Kidney donors (KD) develop a partial loss of renal function defined as Acute Kidney Injury (AKI). Recovery from AKI is due to renal functional reserve (RFR), the capacity of the kidney to increase GFR. The aim of the study was to analyse estimated RFR by radiosotopic test in 30 KD before and 1 year after nephrectomy.
KD mean age at the time of donation was 54.4 years (min-max, 30-78), serum creatinine 0.73 mg/dL (0.5-0.96), eGFR (CKD-EPI) 99 mL/min/1.73m2 (69-119) and radioisotope (51Cr-EDTA) GFR 101.4 mL/min (78-129). The split function was evaluated by concomitant scintigraphy using 99mTc-MAG: the mean percentage of renal function of right kidney was 48% (43-56) and left 52% (44-57), respectively. After nephrectomy all KD worsened renal function with an increase of serum creatinine of 79% (50-112.2%); 25/30 KD developed AKI stage 1, and 5 AKI stage 2 (KDIGO criteria). Seven days after surgery, renal recovery was observed in all cases. These results suggest a potential gain of about 30% in comparison to the starting value of the right kidney. One year after nephrectomy, we studied KD renal function (GFR) by radioisotopic evaluation using 51Cr-EDTA and we compared it with the split radioisotope (51Cr-EDTA) GFR of right kidney at the first evaluation. Mean GFR was 68.8 mL/min (50-87) vs. 48.6 mL/min (39.7-60.4) before donation with an average GFR increase of 20 mL/min (0.8-45.6) and a percentage increase of the right renal function up to 110% (mean 42%, min 1.4%).
Radioisotopic GFR evaluation allows the determination of estimated RFR particularly in medically complex KD. We observed a compensatory hypertrophy due to RFR in all 30 KD independently from age and co-morbidities (elevated BMI and hypertension). We have now started a kidney stress test based on protein load.
CITATION INFORMATION: Cantaluppi V., Guglielmetti G., Mora M., Airoldi A., Orsini F., Quaglia M., Sacchetti G., Ronco C. Radioisotopic Evaluation of Glomerular Filtration Rate (GFR) before and 1 Year after Kindey Donation for Transplantation: The Concept of Estimated Renal Functional Reserve (eRFR) Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Cantaluppi V, Guglielmetti G, Mora M, Airoldi A, Orsini F, Quaglia M, Sacchetti G, Ronco C. Radioisotopic Evaluation of Glomerular Filtration Rate (GFR) before and 1 Year after Kindey Donation for Transplantation: The Concept of Estimated Renal Functional Reserve (eRFR) [abstract]. https://atcmeetingabstracts.com/abstract/radioisotopic-evaluation-of-glomerular-filtration-rate-gfr-before-and-1-year-after-kindey-donation-for-transplantation-the-concept-of-estimated-renal-functional-reserve-erfr/. Accessed May 20, 2019.
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