2125 IMPROVEMENT OF LIVING DONOR'S GLOMERULAR FILTRATION RATE AFTER ONE MONTH IS RELATED TO RECIPIENT'S GLOMERULAR FILTRATION RATE AFTER ONE YEAR

Autor: Christian Villeda Sandoval, Francisco Rodriguez Covarrubias, Bernardo Gabilondo Pliego
Rok vydání: 2013
Předmět:
Zdroj: Journal of Urology. 189
ISSN: 1527-3792
0022-5347
Popis: INTRODUCTION AND OBJECTIVES: Renal function behavior of the donor patient after nephrectomy seems to be related to recipient’s shortand long-term renal function. The objective of this study is to determine if there is relationship between donor and recipient renal function after renal transplantation. METHODS: A retrospective review of our institutional prospectively maintained renal transplant database was performed. Donor-recipient couples were selected for analysis. Estimated glomerular filtration rate (eGFR) using the CKD-EPI formula was calculated. Preoperative and 1 month postoperative eGFR from the donor was used to calculate the improvement in eGFR (“GFRd improvement”). eGFR for the recipient (GFRr) was calculated at 1 and 2 years follow-up. “GFRd improvment” was classified in 3 groups as: 1) a decrease 20% or any increase, 2) a decrease 20% but 40%; and 3) a decrease 40%. GFRr was dichotomized in two groups with 60 ml/min as cut-off point. GFRr differences according to “donor change” groups were calculated. A logistic regression analysis was done to define the impact of “donor change” groups in GFRr. RESULTS: Ninety-six donor-recipient couples were identified. Preoperative and 1 month postoperative donor eGFR were 105.9 16.4 ml/min and 72.5 15.4 ml/min, respectively. Mean “GFRd improvement” was -34.4 14.4%. GFRr was 72.8 20.6 ml/min at year 1 and 79.5 27.6 at year 2 of follow-up. GFRr according to “GFRd improvement” groups was 81.47 11.3 ml/min for group 1, 78.9 20.0 for group 2 and 63.9 19.5 for group 3 (p 0.01). A significant correlation between “GFRd improvement” and GFRr at year 1 was found (Rho 0.252, p 0.04). No correlation was found with GFRr at year 2. Using a logistic regression analysis, “GFRd improvement” classification is a predictor of GFRr 60 ml/min at year 1 (HR 3.879 CI 1.327-11.335, p 0.013). CONCLUSIONS: A sooner improvement of eGFR from donor patients in the first month after donor-nephrectomy is a significant predictor of better eGFR in the recipient after the first year from the transplant.
Databáze: OpenAIRE
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