The 2017 version of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines is the most recent international framework for the evaluation and care of living kidneys donors. Along with the call for an integrative approach evaluating the long-term end-stage kidney disease risk for the future potential donor, several recommendations are formulated regarding the pre-donation glomerular filtration rate (GFR) adequacy with no or little consideration for the donor candidate's age or for the importance of using reference methods of GFR measurements. Herein, we question the position of the KDIGO guidelines and discuss the rationale and modalities for a more basic, but no less demanding GFR evaluation enabling a more efficient selection of potential kidney donors.
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The utility of split function testing in determining recovery of glomerular filtration rate after living kidney donation: a cohort study.
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Background: A number of UK transplantation centres use isotope studies to estimate the relative contribution from each kidney in living kidney donor assessment. The evidence that the estimation of pre-donation split function of the non-donated kidney influences post-donation renal recovery is limited. The aim of this study was to analyse whether, in the context of other donor factors, the split function of the non-donated kidney predicts the percentage recovery of glomerular filtration rate (GFR) at one-year post-donation.
View Article and Find Full Text PDFIntroduction: When GFR is measured (mGFR) using iohexol plasma clearance, results are reported both as a "non-indexed" (mL/min) and "body-surface area (BSA) indexed" to 1.73 m2. When these two values differ, there is no consensus as to which is preferable to use to determine suitability for living kidney donation (LKD).
View Article and Find Full Text PDFAnalyzing body composition in living kidney donors: impact on post-transplant kidney function.
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Department of Surgery, Division of Transplantation Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Living donor kidney transplantation boasts superior patient and graft survival rates compared to deceased donor kidney transplantation. However, the impact of living donor body composition (BC) on post-transplant kidney function remains uncertain. In a cohort of 293 living kidney donor-recipients pairs, we utilized linear mixed model analyses, adjusted for time and including a multiplicative interaction term of time with the donor body composition measure, and found no significant associations between any donor BC measure and the annual change in recipient post-transplantation estimated glomerular filtration rate (eGFR) [donor body mass index (BMI): =-0.
View Article and Find Full Text PDFLongitudinal Trajectories of Estimated Glomerular Filtration Rate in a European Population of Living Kidney Donors.
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Article Synopsis
- Living kidney donors are generally perceived as having optimal health status, although their kidney function, measured by GFR, typically declines post-donation but can improve to about 60-70% of pre-donation levels.
- A study conducted from 2000 to 2017 with 2,716 kidney donors revealed a significant increase in the risk of developing gout/hyperuricemia (adjusted HR 1.73) and chronic kidney disease (CKD) (adjusted HR 6.7) after donation.
- The findings indicate a need for clinical awareness regarding the potential for heightened risks of gout and hyperuricemia in individuals who have undergone kidney donation.
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