Assessing Renal Function for Kidney Donation. How Low Is Too Low?

Autor:	Laham G; Internal Medicine Department, Nephrology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina., Ponti JP; Internal Medicine Department, Nephrology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina., Soler Pujol G; Internal Medicine Department, Nephrology Section, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2022 Feb 02; Vol. 8, pp. 784435. Date of Electronic Publication: 2022 Feb 02 (Print Publication: 2021).
DOI:	10.3389/fmed.2021.784435
Abstrakt:	Kidney transplantation (KT) is the treatment of choice for patients with end-stage kidney disease (ESKD) with decreased morbi-mortality, improved life quality, and reduced cost. However, the shortage of organs from deceased donors led to an increase in KT from living donors. Some stipulate that living donors have a higher risk of ESKD after donation compared with healthy non-donors. The reason for this is not clear. It is possible that ESKD is due to the nephrectomy-related reduction in glomerular filtration rate (GFR), followed by an age-related decline that may be more rapid in related donors. It is essential to assess donors properly to avoid rejecting suitable ones and not accepting those with a higher risk of ESKD. GFR is a central aspect of the evaluation of potential donors since there is an association between low GFR and ESKD. The methods for assessing GFR are in continuous debate, and the kidney function thresholds for accepting a donor may vary according to the guidelines. While direct measurements of GFR (mGFR) provide the most accurate evaluation of kidney function, guidelines do not systematically use this measurement as a reference. Also, some studies have shown that the GFR decreases with age and may vary with gender and race, therefore, the lower limit of GFR in patients eligible to donate may vary based on these demographic factors. Finally, it is known that CrCl overestimates mGFR while eGFR underestimates it, therefore, another way to have a reliable GFR could be the combination of two measurement methods. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Laham, Ponti and Soler Pujol.)
Databáze:	MEDLINE
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