Renal Function Declines in Living Kidney Donors
PHILADELPHIA—Substantial proportions of living kidney donors have diminished renal function one year following their nephrectomy, investigators reported at Kidney Week 2011.
In a study of 169 living kidney donors, Imran Sajjad, MD, and colleagues at Brigham and Women's Hospital in Boston compared donors who had a 25% or greater rise in plasma creatinine from before donation to one year after nephrectomy with those who had less than a 25% increase during that period.
At one year post-nephrectomy, 131 (78%) donors had a 25% or greater increase, 27% had a 50% or greater increase, and 31% had a 0.4 mg/dL or greater increase in plasma creatinine compared with their pre-donation values.
In addition, the researchers found an association between mean arterial pressure (MAP) and a plasma creatinine rise of 25% or greater one year post-nephrectomy. Each 1 mm Hg increment in MAP at the time of donation was associated with a 6% increased risk of having a 25% or greater increase in plasma creatinine.
“There are few data addressing post-nephrectomy kidney function in contemporary living donors,” said Julie Lin, MD, MPH, FASN, senior author of this study. “We were surprised to find that relatively high proportions of donors met established clinical definitions for lower kidney function whereas the general expectation has been for higher levels of recovery at one year. Donors deserve quality information on the expected course of kidney function change after nephrectomy.”
The investigators concluded that further studies and longer-term follow-up are needed to assess the time course of kidney function recovery in living donors.