Presentation Authors: Joon Chae Na*, Min-Gee Yoon, Lee Dongu, Seoul, Korea, Republic of, Hyung Ho Lee, Goyang, Korea, Republic of, Young Eun Yoon, Kwang Hyun Kim, Woong Kyu Han, Seoul, Korea, Republic of
Introduction: The remaining kidney after donation in living kidney donors is known to undergo hyperfiltration. Although hyperfiltration is known to be associated with renal injury its effect on donors after nephrectomy is not well known. In this study we evaluated the occurrence of proteinuria in living kidney donors during the immediate postdonation period, aiming to determine its clinical significance in renal function recovery.
Methods: Urine protein-excretion-rate(PER) and albumin-to-creatinine ratio(ACR) was prospectively collected in 909 living kidney donors. 849 donors with predonation PER < 150mg/24hr were enrolled in the study. Post-donation PER was studied at 4 days after nephrectomy. Donors with post-donation PER < 150mg/24hr were included in the non-hyperfiltration group(n=244), and those with PERâ‰¥150mg/24hr were included in the hyperfiltration group(n=605)
Results: Post-donation eGFR was not significantly different on day 3~5 after nephrectomy but was consistently lower in the hyperfiltration group at from 1week to 1year after nephrectomy. Estimated GFR (MDRD, ml/min/1.73 mÂ²) at 1year after donation was 63.6Â±12.1 in the hyperfiltration group and 68.6Â±12.3 in the non-hyperfiltration group (p=0.001). On multivariable regression analysis presence of immediate post-donation hyperfiltration was an independent predictor of eGFR at 1-year postdonation(Î²(SE)=-2.68(1.15), p=0.02), along with predonation eGFR, age and gender.(Table1) Age and gender were independent predictors of immediate post-donation hyperfiltration on multivariable regression analysis.(Table2)
Conclusions: Hyperfiltration after donor nephrectomy is associated with decreased recovery of renal function. Donors who are older and male are more likely to undergo immediate hyperfiltration after donation.