Risk Factors and 2 Year Outcomes of Low Estimated Glomerular Filtration Rate in the Immediate Post-Operative Period for Living Kidney Donors.
1Henry Ford Hospital, Detroit
2Wayne State University, Detroit
Meeting: 2017 American Transplant Congress
Abstract number: A253
Keywords: Donation, Kidney, Renal function
Session Information
Date: Saturday, April 29, 2017
Session Name: Poster Session A: Living Donor Kidney Transplant I
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall D1
Background: While long-term risk of end-stage renal disease in living kidney donors is considered less than 0.25% at 15 years, an association between the immediate post-operative estimated GFR and long-term outcomes after donor nephrectomy remains to be elucidated.
Methods: From April 2008 to June 2014, 186 consecutive living kidney donors were retrospectively evaluated. eGFR was calculated using MDRD-4 formula. Statistical analysis was done using logistic regression analysis.
Results: The median eGFR on post-operative day 1 (eGFR1) was 51.8mL/min/1.73m2. Risk factors for eGFR1<50mL/min/1.73m2 were age>50years (OR 5.31; p=0.0004) and pre-operative eGFR <100mL/min/1.73m2 (OR 9.96; p<0.0001). Protective factors for loss in eGFR<40% post donation were female sex (p=0.001) and lower pre-operative creatinine (p<0.0001).
| Risk factor for eGFR1<50 (n=186) | N; % or
Mean ± SD |
OR
(Univ) |
p-value | OR
(Multiv) |
p-value |
| Age>50y | 45; 24% | 5.31 | 0.0002 | 4.74 | 0.0004 |
| Sex (Female) | 115; 62% | 3.21 | 0.061 | 1.28 | 0.524 |
| Race (non-AA) | 151; 81% | 3.33 | 0.039 | 1.98 | 0.178 |
| BMI (kg/m2) | 27.6 ± 4.8 | 1.05 | 0.227 | ||
| Pre-op Creat (mg/dl) | 0.8 ± 0.2 | 1.35 | 0.111 | ||
| Pre-op eGFR<100 | 83; 45% | 4.71 | 0.009 | 9.96 | <0.00001 |
| Multiple arteries | 42; 23% | 0.39 | 0.052 | 0.40 | 0.052 |
| Operative time (min) | 251 ± 48 | 1.00 | 0.310 | ||
| Estimated Blood Loss (ml) | 79 ± 66 | 1.00 | 0.456 |
Correlation between post-op creatinine and creatinine at 2 years (n=114) was strongly positive (r=0.692; p<0.0001). Older age (p=0.002) was the only independent risk factor for higher loss of renal function at 2 years (LRF2y>50%). Median recovery of eGFR at 2 years (RRF2y) was 17% of the pre-eGFR. Higher age was an independent risk factor for RRF2y<15% (p=0.001) after multivariate analysis.
Conclusions: Older donors (>50y) may have higher risk for renal dysfunction after nephrectomy and poorer long-term recovery, compared to younger donors. Older donors with pre-donation eGFR less than 100mL/min/1.73m2 should be used with caution.
CITATION INFORMATION: Pahari H, Nagai S, Takahashi K, Tinney F, Denny J, Malinzak L, Rizzari M, Collins K, Yoshida A, Abouljoud M, Kim D. Risk Factors and 2 Year Outcomes of Low Estimated Glomerular Filtration Rate in the Immediate Post-Operative Period for Living Kidney Donors. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Pahari H, Nagai S, Takahashi K, Tinney F, Denny J, Malinzak L, Rizzari M, Collins K, Yoshida A, Abouljoud M, Kim D. Risk Factors and 2 Year Outcomes of Low Estimated Glomerular Filtration Rate in the Immediate Post-Operative Period for Living Kidney Donors. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/risk-factors-and-2-year-outcomes-of-low-estimated-glomerular-filtration-rate-in-the-immediate-post-operative-period-for-living-kidney-donors/. Accessed January 21, 2021.« Back to 2017 American Transplant Congress