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Insufficient early renal recovery and progression to subsequent chronic kidney disease in living kidney donors

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Author(s)
Yaerim KimEunjeong KangDong-Wan ChaeJung Pyo LeeSik LeeSoo Wan KimJang-Hee Cho, Miyeun HanSeungyeup Han Yong Chul KimDong Ki KimKwon Wook JooYon Su KimHajeong Lee
Keimyung Author(s)
Kim, Yae RimHan, Seung Yeup
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean J Intern Med
Issued Date
2022
Volume
37
Issue
5
Keyword
Renal insufficiencychronicEarly renal recoveryLiving donorsKidney
Abstract
Background/Aims:
Renal recovery of a kidney donor after undergoing nephrectomy though challenging is essential. We aimed to examine the effect of estimated glomerular filtration rate (eGFR) percent change at 1-month post-donation on insufficient kidney function after kidney donation.

Methods:
A total of 3,952 living kidney donors who underwent donor nephrectomy from 1982 to 2019 from eight different tertiary hospitals in Korea were initially screened. Percent changes in the eGFR from baseline to 1-month post-donation were calculated. The degree of percent changes was categorized by quartile, and the 1st quartile was regarded as the group with the lowest decreased eGFR at 1-month after donation. The remaining eGFR less than 60 mL/min/1.73 m2 was the end-point. The Cox proportional hazard model was used for evaluating the impact of initial eGFR and eGFR percent change at 1-month post-donation on the condition with remaining eGFR < 60 mL/min/1.73 m2. In the multivariate analysis, we used variables with a p < 0.1 in the univariate analysis.

Results:
A total of 1,585 donors were included in the analysis. During 62.2 ± 49.3 months, 13.7% of donors showed renal insufficiency. The 4th (adjusted hazard ratio [aHR], 10.41; 95% confidence interval [CI], 5.15 to 21.04) and the 3rd (aHR, 4.29; 95% CI, 2.15 to 8.56) quartiles of percent change in eGFR and the pre-donation eGFR (aHR, 0.90; 95% CI, 0.88 to 0.92) were associated with the development of renal insufficiency.

Conclusions:
The impact of worse initial renal recovery on renal insufficiency was pronounced in donors with lower pre-donation eGFRs. Additionally, worse initial renal recovery of remaining kidney affected the long-term development of renal insufficiency in kidney donors.
Keimyung Author(s)(Kor)
김예림
한승엽
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2005-6648
Source
https://www.kjim.org/journal/view.php?doi=10.3904/kjim.2021.308
DOI
10.3904/kjim.2021.308
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44477
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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