scholarly journals P1663CLINICAL AND PATHOLOGICAL FACTORS INFLUENCING RESIDUAL RENAL FUNCTION AFTER LIVING DONOR NEPHRECTOMY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Akihiro Okubo ◽  
Hideki Yokoi ◽  
Kaoru Sakai ◽  
Takeshi Matsubara ◽  
Motoko Yanagita
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
University Hospital ◽  
Kidney Volume ◽  
Nephron Number ◽  
Kidney Donors ◽  
Protocol Biopsy ◽  
Living Kidney Donors ◽  
Post Transplant ◽  
Factors Influencing

Abstract Background and Aims Renal function decreases with aging. Aging is associated with significant changes in structure and function of the kidney. On the macrostructural level, kidney cortical volume decreases, therefore total kidney volume (TKV) also decreases with aging. On the microstructural level, the number of glomerulosclerosis increases, therefore nephron number decreases with aging. Some reports show that the decline of TKV and nephron number is accompanied by a reduction in renal function. However, in the field of living kidney transplantation, TKV and glomerulosclerosis are not fully evaluated as factors influencing the donor’s post-transplant renal function. Living kidney transplantation is an established renal replacement therapy for end-stage renal disease patients. To predict living kidney recipient’s renal function, one-hour protocol biopsy is conducted during the operation. From one-hour protocol biopsy, donor’s pathophysiological findings such as glomerulosclerosis can be evaluated. In this study, we evaluated the correlation of potential influencing factors including TKV and glomerulosclerosis with pre- and post-transplant renal function in living kidney donors. Method This is a retrospective study including all 37 living related kidney donors seen at Kyoto University Hospital from January 2013 to April 2019. Estimated glomerular filtration rate (eGFR) was calculated using equation for Japanese population from serum creatinine levels at pre- and post-transplant. TKV was calculated from the 3D volume-rendered images of enhanced CT (=π/6×length×width×thickness), and adjusted to standard body surface area (BSA) by individual BSA. The ratio of number of non-glomerulosclerosis per that of whole glomeruli (non-GS) was evaluated by protocol renal biopsy at one hour after renal reperfusion. This study protocol was approved by the Ethics Committee on human research of the Graduate School of Medicine, Kyoto University. Results We evaluated 37 living kidney donors (35.1% male, mean age 58.2 ± 12.0 years). Mean pre-transplant eGFR was 75.7 ± 12.1 ml/min/1.73m2, mean post-transplant eGFR; 44.9 ± 7.75 ml/min/1.73m2, adjusted TKV (aTKV); 349.3 ± 58.4 ml, and non-GS; 0.892 ± 0.086. Pre-transplant eGFR was associated with aTKV and aTKV×nonGS (r=0.525, 0.569 respectively, p<0.01). Post-transplant eGFR was associated with age (≧65 years old, p<0.01), aTKV, non-GS, and aTKV×non-GS (r=0.527, 0.344, 0.626 respectively, p<0.05). The rate of eGFR decline was associated with age (≧65 years old, p=0.044), but not with aTKV and non-GS, aTKV×non-GS. Conclusion These results suggest that non-GS and age are correlated with post-transplant renal function but not pre-transplant renal function in living kidney donor, and the decline rate of eGFR are correlated with age.

scholarly journals Impact of Remote Ischemic Preconditioning Conducted in Living Kidney Donors on Renal Function in Donors and Recipients Following Living Donor Kidney Transplantation: A Randomized Clinical Trial

2019 ◽  
Vol 8 (5) ◽  
pp. 713 ◽  
Author(s):  
Ji-Yeon Bang ◽  
Sae-Gyeol Kim ◽  
Jimi Oh ◽  
Seon-Ok Kim ◽  
Yon-Ji Go ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Serum Creatinine ◽  
Ischemic Preconditioning ◽  
Control Group ◽  
Control Groups ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
One Year ◽  
And Control

Although remote ischemic preconditioning (RIPC) has been shown to have renoprotective effects, few studies have assessed the effects of RIPC on renal function in living kidney donors. This study investigated whether RIPC performed in living kidney donors could improve residual renal function in donors and outcomes in recipients following kidney transplantation. The donors were randomized into a control group (n = 85) and a RIPC group (n = 85). The recipients were included according to the matched donors. Serum creatinine (sCr) concentrations and estimated glomerular filtration rate (eGFR) were compared between control and RIPC groups in donors and recipients. Delayed graft function, acute rejection, and graft failure within one year after transplantation were evaluated in recipients. sCr was significantly increased in the control group (mean, 1.13; 95% confidence interval (CI), 1.07–1.18) than the RIPC group (1.01; 95% CI, 0.95–1.07) (p = 0.003) at discharge. Donors with serum creatinine >1.4 mg/dL at discharge had higher prevalence of chronic kidney disease (n = 6, 26.1%) than donors with a normal serum creatinine level (n = 8, 5.4%) (p = 0.003) after one year. sCr concentrations and eGFR were similar in the RIPC and control groups of recipients over the one-year follow-up period. Among recipients, no outcome variables differed significantly in the RIPC and control groups. RIPC was effective in improving early renal function in kidney donors but did not improve renal function in recipients.

scholarly journals Impact of remaining kidney volume to body weight ratio on renal function in living kidney donors

2016 ◽  
Vol 32 (4) ◽  
pp. 185-190 ◽  
Author(s):  
Turun Song ◽  
Zhengsheng Rao ◽  
Yang Qiu ◽  
Jinpeng Liu ◽  
Zhongli Huang ◽  
...  
Keyword(s):  
Renal Function ◽  
Body Weight ◽  
Weight Ratio ◽  
Kidney Volume ◽  
Body Weight Ratio ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals Impact of adjusted kidney volume measured in the bench surgery on one-year renal function in kidney transplantation

PLoS ONE ◽  
2019 ◽  
Vol 14 (11) ◽  
pp. e0224364
Author(s):  
Flávio Vasconcelos Ordones ◽  
Pedro Ivo Rocchetti Pajolli ◽  
Rodrigo Guerra da Silva ◽  
Hamilto Akihissa Yamamoto ◽  
Fernando Fereira Gomes Filho ◽  
...  
Keyword(s):  
Renal Function ◽  
Kidney Transplantation ◽  
Kidney Volume ◽  
One Year ◽  
Bench Surgery

83 Does CT-measured renal cortex volume influence renal function in living kidney donors?

2016 ◽  
Vol 15 (3) ◽  
pp. e83 ◽  
Author(s):  
S. Keito ◽  
K. Okamoto ◽  
K. Ozaki ◽  
T. Tsujioka ◽  
H. Iio ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Cortex ◽  
Kidney Donors ◽  
Living Kidney Donors

scholarly journals Reduced nephron endowment in the neonates of Indigenous Australian peoples

2013 ◽  
Vol 5 (1) ◽  
pp. 31-35 ◽  
Author(s):  
Y. Kandasamy ◽  
R. Smith ◽  
I. M. R. Wright ◽  
E. R. Lumbers
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Filtration Rate ◽  
Blood Pressure Measurement ◽  
Tertiary Care ◽  
Secondary Outcome ◽  
Preterm Neonates ◽  
Kidney Volume ◽  
Nephron Number ◽  
Renal Sonography

Rates of chronic kidney disease (CKD) among Indigenous groups in Australia exceed non-Indigenous rates eight-fold. Using kidney volume as a surrogate for nephron number, we carried out a study to determine if Indigenous neonates have a smaller kidney volume (and thus a reduced nephron number) from birth compared with non-Indigenous neonates. We recruited term and preterm neonates (<32 weeks) at a tertiary care neonatal unit over a 12 months period. Preterm neonates were assessed (renal sonography and renal function measurement) at 32 weeks corrected age (CA) and again at 38 weeks CA when blood pressure was also measured. All term neonates were assessed in the first post-natal week, including renal sonography, renal function and blood pressure measurement. The primary outcome measured was total kidney volume (TKV) and estimated glomerular filtration rate (eGFR) was a secondary outcome. Data was available for 44 preterm (11 Indigenous) and 39 term (13 Indigenous) neonates. TKV of Indigenous neonates was significantly lower at 32 weeks [12.0 (2.0)v.15.4 (5.1) ml;P=0.03] and 38 weeks CA [18.6 (4.0)v.22.6 (5.9) ml;P=0.04] respectively. Term Indigenous neonates also had smaller kidney volumes compared with non-Indigenous neonates. Despite a smaller kidney volume (and reduced nephron number), Indigenous neonates did not have a significantly lower eGFR. Indigenous neonates achieve similar eGFRs to Non-Indigenous neonates, presumably through a higher single nephron filtration rate. This places Indigenous neonates at a greater risk of long-term kidney damage later in life.

scholarly journals APOL1 Genotype and Renal Function of Black Living Donors

2018 ◽  
Vol 29 (4) ◽  
pp. 1309-1316 ◽  
Author(s):  
Mona D. Doshi ◽  
Mariella Ortigosa-Goggins ◽  
Amit X. Garg ◽  
Lihua Li ◽  
Emilio D. Poggio ◽  
...  
Keyword(s):  
Renal Function ◽  
High Risk ◽  
Confidence Interval ◽  
Kidney Donors ◽  
Living Kidney Donors ◽  
Risk Genotype ◽  
Risk Alleles ◽  
Lower Egfr ◽  
Developing Kidney ◽  
Egfr Decline

Black living kidney donors are at higher risk of developing kidney disease than white donors. We examined the effect of the APOL1 high-risk genotype on postdonation renal function in black living kidney donors and evaluated whether this genotype alters the association between donation and donor outcome. We grouped 136 black living kidney donors as APOL1 high-risk (two risk alleles; n=19; 14%) or low-risk (one or zero risk alleles; n=117; 86%) genotype. Predonation characteristics were similar between groups, except for lower mean±SD baseline eGFR (CKD-EPI equation) in donors with the APOL1 high-risk genotype (98±17 versus 108±20 ml/min per 1.73 m2; P=0.04). At a median of 12 years after donation, donors with the APOL1 high-risk genotype had lower eGFR (57±18 versus 67±15 ml/min per 1.73 m2; P=0.02) and faster decline in eGFR after adjusting for predonation eGFR (1.19; 95% confidence interval, 0 to 2.3 versus 0.4; 95% confidence interval, 0.1 to 0.7 ml/min per 1.73 m2 per year, P=0.02). Two donors developed ESRD; both carried the APOL1 high-risk genotype. In a subgroup of 115 donors matched to 115 nondonors by APOL1 genotype, we did not find a difference between groups in the rate of eGFR decline (P=0.39) or any statistical interaction by APOL1 status (P=0.92). In conclusion, APOL1 high-risk genotype in black living kidney donors associated with greater decline in postdonation kidney function. Trajectory of renal function was similar between donors and nondonors. The association between APOL1 high-risk genotype and poor renal outcomes in kidney donors requires validation in a larger study.

Sign in / Sign up

Export Citation Format

Share Document